A short list of some of the published articles
authored / co-authored by Versha Rajeev:
1. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
2. Antiseptics, Disinfectants and COVID-19 – THE ANTISEPTIC, Vol. 117,
No. 11, pp. 26 – 28, 2020
3. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
4. The Conundrum of COVID-19 Vaccines – THE ANTISEPTIC, Vol. 118, No. 1, 2021
5. The Good and the Bad of Honey
FEAR and COVID-19
Ms. Versha Rajeev
Freelance Writer,
74, Kalliampudur Road, Perundurai, Erode District,
Tamil Nadu – 638052
Dr. T. Rama Prasad
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052.
µ Vol. 98 • NOVEMBER 2020 HEALTH 31
Email: admin@theantiseptic.in www.theantiseptic.BEol. Vol. 98 No. 11 NOVMBER 2020
CONTENTS
WATCHING THE BREATH .......................................................................04 FASHIONABLE FRUIT: PASSION FRUIT
.........................................................................Mrs. S. Suja Kumari..........09 HEALTH BENEFITS OF CINNAMON (DALCHINI) WITH MILK
...............................................................Dr. Vijay Kumar Gauttam..........11 HEALTH BENEFITS OF PAPAYA LEAVES
............................................................................Mrs. Manimegalai...........13
9 WAYS CRYING MAY BENEFIT YOUR HEALTH ...............................17 STOMACH FLU ...........................................................................................19 FEVER IS A SYMPTOM, NOT A DISEASE
.....................................Dr. Amandeep Kaur, Mr. Khushal Nanda ..........22 INVESTIGATIONS IN FEVER
.......................................................................... Ms. Shilpa Choudhary.......27 FEAR AND COVID-19
............................Ms. Versha Rajeev, Dr. T. Rama Prasad .................31
CHILDHOOD DEPRESSION .......................................................................33
SAVE YOUR KIDNEYS - 41 ...........................................................................Dr. Sanjay Pandya.............35
RELATIONSHIP - LIVING IN HARMONY-14...........................................37
FEAR and COVID-19
‘Infodemic’
The greatest damage that this COVID-19 pandemic did and will do is of infusing FEAR into our blood. The ‘INFODEMIC’ is the real pandemic destroying health and economy through fear which leads to needless thoughts and disastrous interventions. We are drowned and suffocated with information, misinformation and fake information. Fear, fear and fear. When it is said that a normal person without any symptoms can potentially transmit this virus through normal breathing, how can one be without fear ?
Undue Fear
Doctor is afraid of seeing a patient. Patient is afraid of being tested. Homemaker is afraid of a housemaid. Maid is afraid of a coughing child in the house. Employee is scared of going for work. Employer is worried about closure of the factory if an employee tests positive. One is scared of touching a newspaper. Another is afraid of using sugar without washing it ! We are afraid of each other. What life is it ?
Stress Kills
Already many of the diseases in the ‘modern’ world are due to stress. Now, Covid is adding fuel to the fire, immensely enhancing fear, tension and stress leading to mental illnesses which in their turn lead to physical illnesses. Fear destroys immunity and stress kills. Sooner and later, directly and indirectly, there could be enormous morbidity and mortality due to fear and stress, much more than due to the virus illness. The impact would be more due to the fear of loss of life and the stress of economic crunch, consequent to the ongoing disruptions in supply and production across the world. Uncertainty of everything is the greatest stress.
Not Too Deadly
Though COVID-19 is exceptionally infectious, it is not very lethal. In fact, 90% of the cases in India had no or minor symptoms, and deaths are less than 4%. So, get rid of the FEAR first. On a larger canvas, the damage done by the virus does not seem to be huge, especially in India. For instance, around one lakh people died in India as on October 15, 2020 in nine months due to COVID-19. It is a small number compared to 4,35,000 deaths due to TB annually or 1,50,000 deaths due to road accidents per year, in India. How about the deaths due to other diseases ? Too many. Just look at the figures for the lockdown period of 6 weeks (March 25 to May 5) -- India’s pro-rated death toll from all causes would be 10 lakhs, including due to -- influenza and pneumonia of 75,000, TB of 54,000, diarrhoea of 50,000, road accidents of 32,000 and suicides of 24,000. Hence, the small number of corona deaths need not cause any fear. Get rid of the FEAR first. Otherwise one becomes mentally imbalanced. In India, 7.5% of the population suffers from mental disorders, according to the WHO. And It is estimated that the ‘lockdown-stress’ would increase this illness by 20%.
µ Vol. 98 • NOVEMBER 2020 HEALTH 31
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
The Hindu (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. DIGITAL CLUBBING and HYPERTROPHIC PULMONARY OSTEOARTHROPATHY - Pathogenesis --
The Antiseptic, Vol. 76. pp. 213-215, 1979.
2. CHILDHOOD TUBERCULOSIS - Part I -- The Antiseptic, Vol. 76, pp. 449 - 504, 1979
3. CHILDHOOD TUBERCULOSIS - Part II -- The Antiseptic, Vol. 76, pp. 567 - 574, 1979
4. STEVENS-JOHNSON SYNDROME and THIOACETAZONE -- The Antiseptic, Vol. 77, pp. 99 -102, 1980
5. HIGHLY PURIFIED INSULINS - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
7. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
9. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
10. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 --
……http://www.thehindu.com/opinion/open page/article2801701.ece
11. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012 --
...http://www.thehindu.com/opinion/open-page/article3340116.ece
12. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 --
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
13. A BAD PATCH - The Hindu, Open Page, March 15, 2020 --
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
14. YELLOW NAIL SYNDROME - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
15. YELLOW NAIL SYNDROME - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
16. DRUG RESISTANCE in TUBERCULOSIS - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
A short list of some of the published articles authored / co-authored by Versha Rajeev:
1. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
2. Antiseptics, Disinfectants and COVID-19 – THE ANTISEPTIC, Vol. 117,
No. 11, pp. 26 – 28, 2020
3. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
4. The Conundrum of COVID-19 Vaccines – THE ANTISEPTIC, Vol. 118, No. 1, 2021
5. The Good and the Bad of Honey
VACCINE CROCODILES
COVID CROCODILES
Dr. T. Rama Prasad, Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu. Presently: Director of PAY WHAT YOU CAN Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com
Versha Rajeev, Freelance Medical Journalist, 74, Kalliampudur Road, Perundurai, Erode District, Tamil Nadu – 638052
In the ‘covid-times’, we are like Schrodinger’s cat – both alive and dead, what with the looming ‘cytokine storms’. The Nobel Laureate Erwin Schrodinger devised the famous ‘thought experiment’ of putting a cat and some lethal things inside a box to see whether the cat would be alive or dead in order to prove a point in quantum physics. Until one opens the box, the cat is supposed to be both alive and dead !
We don’t know what experiments the Brazilian President Bolsonaro conducted, but he aired that a COVID-19 vaccine could turn people into crocodiles; females into males; males into females. And, we have a choice – choice to continue to be humans by denying vaccination.
Vaccine experts are advising people ‘not’ to get pregnant within a few months of vaccination. With the arrival of the vaccine, a lady asked: “Doctor, in case of an accidental pregnancy, are the chances more for a baby crocodile or a baby monkey ?” This lady, who worked on a thesis of ‘origin of species’ is thinking more in favour of a monkey. But our family members believe the living legend Bolsonaro in Brazil more than the dead Charles Darwin resting in Westminster Abbey in London. So, we decided to rent a house near the lake of ‘Vellode Bird Sanctuary’ which is a few kilometres from us. The rationale of this idea is that we can have an easy access to the lake when we eventually become crocodiles after the inevitable vaccination. Moreover, it’s a better option to be a crocodile in a lake than to be a guinea pig in a ‘Covid ICU’. It’s a double benefit -- escaping from the jaws of death and having the jaws to chew the exotic migratory birds visiting the sanctuary ! Thanks to the ‘anti-vaxxer’ celebrity Bolsonaro.
On a mildly lighter note, if there is a good side-effect of turning people into honest, selfless, caring and transparent ones, the vulnerable corrupt citizens (notoriously high in number) must be included as the first in the priority groups in vaccination ! Voila !
Corona converted presidents into clowns
(As on March 26,2021, there were 3,00,000 deaths due to Covid in Brazil which according to former president of Brazil Luiz Inacio Lula da Silva were caused by “the virus-sceptical far-right” President Bolsonaro. Lula termed it as “genocide.”)
June 20, 2021
The number of deaths related to Covid-19 has passed 500,000 in Brazil, the second-highest in the world, as experts say the outbreak could worsen amid slow vaccination and the start of winter.
The virus continues to spread as President Jair Bolsonaro refuses to back measures like social distancing.
The health institute Fiocruz says the situation is "critical". Only 11% of adults are fully vaccinated.
Tens of thousands of Brazilians joined anti-government protests on Saturday.
President Bolsonaro has been heavily criticised for not implementing a co-ordinated national response and for his scepticism toward vaccines, lockdowns and mask-wearing requirements, which he has sought to loosen.
· Covid - what's gone wrong in Brazil?
· Why are so many babies dying of Covid-19 in Brazil?
· What happened when a whole town got Covid jabs?
The country has reported, on average, 70,000 cases and 2,000 deaths daily in the past week. Most of the new infections and deaths were among people aged 20-59, Fiocruz said, warning that the start of winter in the southern hemisphere, next week, could result in more infections.
ANTISEPTICS, DISINFECTANTS and COVID-19
RAMA PRASAD T, VERSHA RAJEEV
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com
Ms. Versha Rajeev,
Freelance Writer, 74, Kalliampudur Road, Perundurai, Erode District, Tamil Nadu – 638052
Specially Contributed to “The Antiseptic”
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 117 No. 11 NOVEMBER 2020 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
`
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 117 No. 11 NOVEMBER 2020 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
EDITORIAL
Acute Respiratory Distress syndrome (ARDS) .......09
GENERAL
Innovation in API - Indian Market 2020 Sanjay Agarwal...........................................................................................10
Medicine pricing in country should be in the interest of citizenry
Ahmad Faisal, Vijay Thawani, Rimjhim Sahu .............................................12
Healthians Study Reveals an astounding 11.45% rise in diabetic patients
during lockdown Sonal Saxena ……………………… ……....16
Current efficacious management of Parkinsonism Rimjhim Sahu, Vijay Thawani...............................................................................................19
Effectiveness of Planned Teaching Programme on Prevention of Catheter Associated Urinary Tract Infection (CAUTI) in Patients with Indwelling Catheter in terms
of Practice among Staff Nurses Working in ICU Deepthy James ............................................................................................24
Antiseptics, Disinfectants and COVID-19
Rama Prasad T., Versha Rajeev...................................................................26
CASE REPORT
Hemichorea - Hemiballismus Syndrome – A rare initial presentation of new onset non Ketotic Diabetes Mellitus
Gopalakrishnan Chandrasekaran, Anandkumar Annamalai, Amalraj Iyadurai, Kokila Rajan,
Vinothkumar Gopal, Suresh Madasamy .........................................................................................................................29
ALTERNATIVE MEDICINE
Iron deficiency anemia in children Pooja S. Sonawane, Naina P. Vishwakarma ..................................................................................................31
Critical review of Shirovirechan Drugs in Urdhwajatrugata Vikara
Kiran B. Patil, Balaji S. Pawar .....................................................................33
Abnormal Uterine Bleeding Vijayalaxmi Chindak .......................................................................................35
Review Article on Goghrita Hemalata Shrishail Kore, Shamkumar Krishnarao Karvekar...................................................................37
Ayurvedic Management of Vatakaphaja Unmada w.s.r. to ADHD in Children –
A Case Report Kaveri Hulyalkar, Mahadev P. Mangane, Veena K.H., Mohit .........................................................................................39
Role of Garbhaja Bhawas in Autoimmune Disorders
Lalit Tiwari, Shashikant Tiwari, Ruby Rani Agarwal .........................................................................................................................42
Occasional Review .........................................................................................................................46 Gleanings ..........................................................................................................................47 Glimpse into history ..........................................................................................................................48 Case of the month ..........................................................................................................................49 Medi Quiz
......................................................................................................……..............50
THE ANTISEPTIC Vol. 117 • November 2020
ANTISEPTICS, DISINFECTANTS and COVID-19
RAMA PRASAD T, VERSHA RAJEEV
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District,
TN – 638052. drtramaprasad@gmail.com
Ms. Versha Rajeev,
Freelance Writer, 74, Kalliampudur Road, Perundurai, Erode District, Tamil Nadu – 638052
Specially Contributed to “The Antiseptic” Vol. 117, No. 11, November 2020
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
The Antiseptic
It must be interesting to note that a premier Indian journal of medicine and surgery which was first published in 1904 was christened “THE ANTISEPTIC”. Louis Pasteur’s ‘Germ theory of putrefaction’ inspired Joseph Lister to introduce ANTISEPTICS to the world through his paper “Antiseptic Principle of the Practice of Surgery” in 1867. The British surgeon, JOSEPH LISTER was the pioneer and founder of ANTISEPTIC SURGERY. The year 1867 represents a watershed in the history of ANTISEPTICS when he used carbolic acid as a first-ever ANTISEPTIC1. Nostalgic memories prompt me to mention that my (T. Rama Prasad) first article in THE ANTISEPTIC was published 40 years ago – Vol.76.pp.213-215, 1979 !
Musings
HEALTH experts warned people against injecting or ingesting DISINFECTANTS after the POTUS thought aloud on April 23, 2020 about injecting disinfectants to combat COVID-19. The media sensationalized the uttering and made the flabbergasted people across the globe gossip and critically comment about the disinfectant injections. After all, this apparently incredulous remark may just be a witty expression made in a lighter vein. Whatever it is, even before this verbal explosion, accidental poisonings due to disinfectants were on the rise due to their increased use meant to ward off the relentless march of the virus SARS-CoV-2. According to the AAPC Center, there were 2,019 disinfectant-related poisoning cases in April 2019 and 3,609 in April 2020 in the US. Of course, the increase was not due to injections of disinfectants ! But the presidential megaphone may have further unwittingly increased the disinfectant demand. The delusive idea of the injections is one of a parade of fallacies and follies emanated from exuberant hubris and hegemony in the battle against the formidable virus.
What are these agents ?
The words “ANTISEPTICS” and “DISINFECTANTS” are generally used as synonyms. But, in fact, they are different, though they serve the same purpose mostly. Yet, some call antiseptics as “skin disinfectants.” Antiseptics are applied to skin surfaces, mucus membranes or wounds – hands, mouth, throat, ulcers, bladder, etc. Disinfectants are applied on surfaces of commonly used objects -- door handles, tabletops, countertops, gadgets, floors, walls, equipment, building premises, vehicles, roads, etc. In short, antiseptics are applied on living surfaces and disinfectants on non-livingsurfaces. Neither is meant for ingestion or injection. These are universally recommended to prevent spread of COVID-19 through infected surfaces. They are not a panacea, though, since they are not totally effective, but may act to a varied extent on this ‘novel coronavirus’. The available information about the virus SARS-CoV-2 and the disease COVID-19 is patchy and ill-understood. Antiseptics and disinfectants may block the pathway of transmission of this virus to some extent.
Antiseptics and disinfectants are antimicrobial agents that stop or slow down the growth of various microbes like bacteria, viruses, fungi, spores, etc. Disinfectants are more powerful and toxic than antiseptics as they contain different chemicals (‘biocides’, as some call them) though they serve almost the same purpose. They are extensively used in hospital settings and public healthcare programmes. And now with the ‘tsunami’ of COVID-19, they are universally in use for compelling reasons. While the economy has tanked during the pandemic, the escalated demand for these items has exponentially propelled the global ‘disinfectants and antiseptics market’ which was valued at $16.75 billion in 2018.
Antiseptics
During the first six months of this pandemic, before the “aerosol / airborne” theory of transmission was accepted, a lot of emphasis was placed on ‘hand sanitization’ with antiseptics or soap and water2. On the other hand, a very recent study from Japan published on October 3, 2020 found that SARS-CoV-2 virus survives for nine long hours (compared to 2 hours of IAV) on human skin, underscoring the importance of hand hygiene3. Alcohol-based antiseptic is on the list of ‘Essential Medicines’ of the WHO. ‘Covid or no-covid’; ‘aerosol or droplet’, hand hygiene is of paramount importance to keep many diseases at bay.
Hand sanitizers were first introduced in 1966 in medical settings though they became popular only after 1990. Antiseptics are more widely used by the people during pandemics because of hygiene advisories. They come in various forms such as solution, hand-wash, hand-rub, hand-spray, gels, creams, etc. There are two main types – ALCOHOL-BASED and ALCOHOL-FREE. For the purpose of preventing COVID-19, only alcohol-based ones are recommended.
Alcohol was used as an antiseptic as early as 1363 and gained evidence-based support since 1867. Alcohol-based versions typically contain isopropyl alcohol, ethyl alcohol (ethanol) or n-propanol of 60% to 95%. Antiseptics containing more than 60% of alcohol are effective against the ‘corona virus’. Hand-rubs containing 90% alcohol are more effective against viruses though their prolonged and frequent use may give rise to skin problems. Isopropyl alcohol kills 99.99% of all non-spore forming bacteria in less than 30 seconds. Using low quantities such as 0.3 ml or of alcohol of less than 60% may not only be ineffective against the SARS-CoV-2 but also may develop drug-resistant organisms. Recommendations of EN12054 must be followed for uniformity and efficacy. Surgery-specific hand-rubbing techniques like EN1499 (hygienic hand wash) and EN1500 (hygienic hand disinfection) are worth following. The WHO issued cost-effective recommendations for hand-rub formulations to guard against COVID-19 -- Ethanol 80% (or Isopropyl alcohol 75%) + Glycerol 1.45% + Hydrogen peroxide 0.125%, all v/v4. Here after, ‘Hand Sanitizing Stations’ in public places may become commonplace.
Alcohol-free versions may contain benzalkonium chloride, povidone iodine, hydrogen peroxide or even triclosan which is not safe. These are less effective than the alcohol-based ones. Octenidine dihydrochloride is increasingly being used in continental Europe. Some of these antiseptics contain povidone iodine, chlorhexidine gluconate, biguanides, chloroxylenol, hydrogen peroxide, etc.
Hazards
Overuse of antiseptics resulted in skin problems, even for doctors. One should not become obsessive and go overboard. COVID-19 has upended everything and made many people overuse antiseptics and disinfectants out of anxiety and obsession. Alcohol may deprive the skin of the outer layer of protective oil. This may have negative effects on barrier function of the skin, and it is more so if an antimicrobial detergent is present in the sanitizer. Compounds such as glycerol are added to prevent drying of the skin. Sometimes, preservatives, fragrances and ‘Quats’ such as benzalkonium are added which may give rise to sticky feeling and allergic reactions. Quats (quarternary ammonium compounds) may cause asthma, dermatitis, superbugs, infertility, birth defects, etc. While antiseptics are generally safe, it is better to avoid needless and excessive use. They are sometimes misused because of their alcohol content. During the COVID-19 pandemic, in New Mexico, seven alcohol addicts drank sanitizers for the alcoholic effect. Three of them died and one had gone blind.
Spurious stuff
There are umpteen number of brands of antiseptics. Those with excessive levels of methanol which is toxic are to be avoided. Because of the excessive presence, in June 2020, the FDA of the US issued an advisory against a product of Eskbiochem SA de CV company in Mexico. The FDA banned 24 ingredients in antiseptic preparations – triclosan is one of them. While substandard PPE suits and N95 masks flooded the markets during the throes of the pandemic, several spurious antiseptic brands made brisk business. Fraudulent labelling of alcohol concentration in antiseptics had been a problem in Guyana and some other countries.
Soap and water
Washing hands with soap and water is equally good, and even better when the hands are visibly soiled with dirt, grease and chemicals, and is very much cheaper than hand sanitizers. And also, one may get rid of certain kinds of germs such as Norovirus virus, Claustridium difficile bacterium, Cryptosporidium parasite and some spores, which can’t be tackled by hand sanitizers. The “Clean Hands” campaign of the US Centers for Disease Control and Prevention (CDC) advised the public to use alcohol-based sanitizers ONLY IF soap and water are NOT available. In fact, washing with soap and water is SAFER, as some sanitizers may promote development of drug-resistant organisms on prolonged usage.
Disinfectants
Disinfectants are graded by “phenol coefficient” factor, as phenol has been a long-known disinfectant. Numerous brands are available in the market. Chlorine bleach / sodium hypochlorite is an inexpensive and fast-acting one. It is effective against a myriad of microbes – most of the common pathogens, TB bacilli, hepatitis B and C viruses, some other viruses, some fungi, some parasitic organisms, etc. Studies are still going on to find the impact of disinfectants on this new virus. For safety reasons, they should be used strictly according to instructions. Even governments used them wrongly by forcing people to go through “disinfectant tunnels” during the ‘corona crisis’. The Supreme Court also found fault with the authorities in this matter. In some places, disinfectants were sprayed on people which is unscientific, barbarous and very hazardous. Most disinfectants, by nature, are potentially harmful and even toxic to humans and animals. Detailed guidelines on disinfection of common public places including offices to guard against COVID-19 are provided in a notification5.
Ultraviolet light
Sunlight and heat inactivate SARS-CoV-2 virus. Sunlight’s ultraviolet (UV) rays are also disinfectants, but the Earth’s Ozone layer blocks most of the effective wave length of the UV rays to a great extent. Ultraviolet-emitting lamps are better than sunlight and are being used in hospitals for disinfection. These may be more necessary now as it has come to be known that the ‘corona virus’ can spread over longer distances due to “aerosol / airborne” transmission2. The scientific slogan “SUNLIGHT IS THE BEST DISINFECTANT” was popularized in 1913 by Justice LOUIS BRANDEIS of the Supreme Court of the US. Curiously, more than a century later, the “SUNLIGHT DISINFECTANT INJECTION” theory spread worldwide like wildfire, touted by one who wondered as to why the sunlight which kills the “China Virus” in one minute shouldn’t be “injected” into the body !!! Who else has the chutzpah to say that except the audacious and quirky POTUS ! People don’t have a good funny bone to enjoy political humour !!! And, OZONE room air disinfectants are also being promoted to combat microbes, in addition to ionizers.
Miramistin
Miramistin, an antiseptic, was developed in the Soviet Union during the Cold War for use in orbital satellite stations. Considering the emerging microbial resistance to the currently used antiseptics, this novel, low toxicity molecule may be a desirable alternative. As this was not used outside ‘Prior Soviet Block Countries’, resistance to this antiseptic may be very low6. Just as is the case with antibiotics, a search is on to find more effective and safe antiseptics and disinfectants, what with studies showing viability of SARS-CoV-2 on human skin for nine hours.
Covid Effect
COVID-19 is redefining the ‘blind privilege’ of the established antiseptics and even of the ‘modern medicine’itself, for that matter. The virus has exposed the hollowness of the so-called ‘evidence-based modern medicine’ by killing over 200,000 people in a few months in the US which brags about its supreme status of crème - de - la – crème of medical care on the planet, and by brushing aside the ‘world-class’ treatment given to the legendary singer SPB who walked into a ‘high-end’ hospital as an almost normal person but didn’t come out alive even after 52 days of ‘intensivemodern medical care’. COVID-19 has taught us to take death as a corollary of life, than as a medical failure !!! It left nothing as sacrosanct, even the sacred temples.
REFERENCES
1. https://hekint.org/2017/01/22/joseph-lister-and-the-story-of-antiseptic-surgery/
2. https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa939/5867798
3. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1517/5917611
4. https://www.ncbi.nlm.nih.gov/books/NBK144054/
5. https://www.mohfw.gov.in/pdf/Guidelinesondisinfectionofcommonpublicplacesincluding offices.pdf
6. https://academic.oup.com/femsre/article/44/4/399/5835225
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
The Hindu (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. DIGITAL CLUBBING and HYPERTROPHIC PULMONARY OSTEOARTHROPATHY - Pathogenesis --
The Antiseptic, Vol. 76. pp. 213-215, 1979.
2. CHILDHOOD TUBERCULOSIS - Part I -- The Antiseptic, Vol. 76, pp. 449 - 504, 1979
3. CHILDHOOD TUBERCULOSIS - Part II -- The Antiseptic, Vol. 76, pp. 567 - 574, 1979
4. STEVENS-JOHNSON SYNDROME and THIOACETAZONE -- The Antiseptic, Vol. 77, pp. 99 -102, 1980
5. HIGHLY PURIFIED INSULINS - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
7. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
9. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
10. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 --
……http://www.thehindu.com/opinion/open page/article2801701.ece
11. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012 --
...http://www.thehindu.com/opinion/open-page/article3340116.ece
12. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 --
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
13. A BAD PATCH - The Hindu, Open Page, March 15, 2020 --
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
14. YELLOW NAIL SYNDROME - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
15. YELLOW NAIL SYNDROME - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
16. DRUG RESISTANCE in TUBERCULOSIS - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
A short list of some of the published articles authored / co-authored by Versha Rajeev:
1. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
2. Antiseptics, Disinfectants and COVID-19 – THE ANTISEPTIC, Vol. 117,
No. 11, pp. 26 – 28, 2020
3. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
4. The Conundrum of COVID-19 Vaccines – THE ANTISEPTIC, Vol. 118, No. 1, 2021
5. The Good and the Bad of Honey
TEA and COVID-19
Dr. T. Rama Prasad
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu, drtramaprasad@gmail.com
Presently: Director, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052.
Ms. Versha Rajeev (Co-author)
Freelance Writer, 44, Kalliampudur Road, Perundurai, Erode District, Tamil Nadu – 638052.
Email: admin@theantiseptic.in www.theantiseptic.BEol.
Vol. 98 No. 10 OCTOBER 2020
Email: admin@theantiseptic.in www.theantiseptic.BEol.
Vol. 98 No. 10 OCTOBER 2020
CONTENTS
TEA AND COVID –19 ..... Dr. T. Rama Prasad, ……… Ms.Versha Rajeev.............. ............04
EASY WAYS TO ESCALATE YOUR IMMUNITY ...........................Mrs. S. Suja Kumari......09
VARSHA RITUCHARYA
..... Dr. Abhijeet Manmath Morale ………....................................13
CURLY HAIR................................................................................................................................15
DIET CHART FOR A HEALTHY HEART …………………….............Ms. S, Suja kumari........17
NUTRITION GUIDANCE FOR ADULTS DURING COVID PANDEMIC ……..Mrs. C. Priyamvadha.......19
BEAUTY TIPS OF CURD ...................................................................Mrs. J.V. Jeevitha............21
THE IMPACT OF COVID-19 ON CHILDREN .......................................Mr. V.R. Aneesh.........22
PLASMA THERAPY.....................................................................................................................24
EYE IRRITANTS...........................................................................................................................26
DRY SOCKET................................................................................................................................28
SJOGREN’S SYNDROME .................Dr. Amol Ganesh Malekar, Dr. Sujata Deepak Kate........30
BURKITT LYMPHOMA ..............................................................................................................33
SAVE YOUR KIDNEYS - 40 .............................................................Dr. Sanjay Pandya............36
RELATIONSHIP - LIVING IN HARMONY-13..........................................................................38
TEA AND COVID-19
Dr. T. Rama Prasad
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu, drtramaprasad@gmail.com
Presently: Director, PAY WHAT YOU CAN Clinic, Perundurai, Erode District, TN – 638052.
Ms. Versha Rajeev (Co-author)
Freelance Writer, 74, Kalliampudur Road , Perundurai, Erode District, Tamil Nadu – 638052.
As the world reels from the impact of COVID-19, the globally popular tea added its own flavour to the Corona confusion. It has become a subject of debate – some saying that ‘A teacup a day keeps the Covid away’ ! And some have gone to the basics to know whether tea is good or bad for health, in general, notwithstanding the fact that tea is the world’s most consumed drink, after water. Tea is the preferred choice for many, given its low caffeine content and the perceived health benefits. It has an exciting historical background.
Fake News
While tea industry is grinding to a halt because of the logistics of lockdowns around the world, tea is making grand rounds on the Internet. Various social media flashed news about benefits of tea in containing COVID-19. One hurriedly published article (which was later retracted) in the “We Chat” account of Zhejiang CDC on Feb 26, 2020 claimed that drinking tea may help prevent COVID-19, based on the evidence that tea inhibited proliferation of the virus in vitro. Added to this, is the circulating news that the whistle-blower Chinese ophthalmologist, Dr. Li Wenliang (who died of coronavirus) had documented evidence to support that tea has anti-coronavirus properties, and that tea was being given 3 times a day to patients in hospitals in China. This seems to be a big fat fake news.
Projected Evidence
Dr. Sanjay Kumar, Director, Institute of Himalayan Bio-resource Technology (IHBT) screened 65 biochemical polyphenols from tea which may block the activity of SARS-CoV-2 virus better than some drugs. Ramaz Chanturiya, at the ‘Rus teacoffee’ lobby in Russia said that tea, combined with lemon, boosts the immune system. Various brands of green tea, herbal tea and Kangratea are available in the market. Some of them cite recommendations by Ministry of AYUSH and Ministry of Science and Technology.
Research Studies
The amount of time the leaves are processed determines the type of tea – green, black or Oolong. Green teas are the least processed and tend to have the highest amounts of polyphenols, and the only type that contains the polyphenol called Catechin – epigallocatechin (EGCg). Most of the research studies are done with green tea which contains flavonoids and anti-oxidants that may improve overall health, lower blood pressure, protect teeth, prevent cancer, etc. There is a lot of research literature out there on the benefits of tea on cardio-vascular system and other organs. A seven-year study published in the European Journal of Preventive Cardiology (2016) indicated that regular consumption of tea reduces cardiovascular and stroke problems. And, of course, there is a lot about the bad effects due to excessive consumption which may be due to fluoride, aluminium, tannins, oxalates, caffeine, etc. The side effects may be anxiety, restlessness, head ache, sleep disturbance and digestive problems. Just as with any other food product in the market, sponsored and biased research has been going on to falsely project some health benefits to boost tea trade.
Soaring Demand
With the pandemic confining people to indoors, global demand for tea has gone up. According to the market research firm Kantar, British people working from home due to lockdowns splashed out an additional 10 million pounds on tea during the three months from April to June 2020. The British drink almost 36 billion cups of tea per year ! Chai(tea) is India’s national drink. India, along with four other countries (China, Kenya, Sri Lanka and Vietnam) account for 82% of total global tea supply. May 21 is observed as International Tea Day.
Myriad Varieties
Camellia sinensis is the botanical name of the tea plant. There are many different varieties of tea like Darjeeling and Chinese green. Through centuries, a variety of blends of tea have evolved. Tea has become a huge emotional anchor for people in India who are wedded to it. A redolent and routine drink, tea has come to stay. It inspired aficionados and connoisseurs to brew a myriad of varieties -- oolong, green, black and even white. They established their presence in a wide range of eateries -- roadside mobile stalls to premium five-star hotels. One brand “Radhikas Fine ... Teas & Whatnots” offers 55 flavours of tea, experimenting with a variety of blends, infusions, floral notes and tissues to tickle and satiate the taste buds of tea lovers who visit a wide spectrum of facilities ranging from quirky and quaint joints to premium lounges and resorts.
To tide over the stagnancy in tea-shop business recently due to the ‘Novel Corona’ lockdowns, novel varieties of tea are introduced in Nilgiris of Tamil Nadu -- Blue Tea, Virgin Green, Long Ding, Twirl Green, White Tea, Neo Oolong, Garam Masala Chai, Saffron Chai, Silver Needle, Gujarati Kawa, Kashmiri Kawa, etc. The tea experimenters and connoisseurs are tasting and evaluating them.
Tea and Corona
The claims and the focus now is about the benefits of tea in boosting immunity against the coronavirus infection. At present, there is no robust evidence to positively state that tea prevents or cures COVID-19, but it may have a beneficial effect in a general way just as we gain immunity through various vegetable-based food items which we consume traditionally and routinely.
How much is good ?
Tea is used mainly as a routine beverage like coffee. The benefits go beyond refreshment. It has a stimulating effect in humans, primarily due to its caffeine content which is half of coffee. A cup of tea (240 ml) contains 20 to 60 mcg of caffeine, and less than 200 mcg (about 4 cups) per day is permissible. Moderate intake of tea (up to 4 cups – 950 ml -- per day) is good for health for most people, but too much of it may be detrimental. One or two cups a day may be ideal. It is also used for its medicinal values by various ethnic groups.
For further reading :
https://www.thehindu.com/opinion/open-page/of-tea-coffee-and-commerce/article5567951.ece
https://drtramaprasad.blogspot.com/2017/04/tea-coffee-and-commerce_30.html
HEALTH Vol. 98 • OCTOBER 2020
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
The Hindu (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. DIGITAL CLUBBING and HYPERTROPHIC PULMONARY OSTEOARTHROPATHY - Pathogenesis --
The Antiseptic, Vol. 76. pp. 213-215, 1979.
2. CHILDHOOD TUBERCULOSIS - Part I -- The Antiseptic, Vol. 76, pp. 449 - 504, 1979
3. CHILDHOOD TUBERCULOSIS - Part II -- The Antiseptic, Vol. 76, pp. 567 - 574, 1979
4. STEVENS-JOHNSON SYNDROME and THIOACETAZONE -- The Antiseptic, Vol. 77, pp. 99 -102, 1980
5. HIGHLY PURIFIED INSULINS - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
7. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
9. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
10. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 --
……http://www.thehindu.com/opinion/open page/article2801701.ece
11. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012 --
...http://www.thehindu.com/opinion/open-page/article3340116.ece
12. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 --
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
13. A BAD PATCH - The Hindu, Open Page, March 15, 2020 --
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
14. YELLOW NAIL SYNDROME - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
15. YELLOW NAIL SYNDROME - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
16. DRUG RESISTANCE in TUBERCULOSIS - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
A short list of some of the published articles authored / co-authored by Versha Rajeev:
1. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
2. Antiseptics, Disinfectants and COVID-19 – THE ANTISEPTIC, Vol. 117,
No. 11, pp. 26 – 28, 2020
3. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
4. The Conundrum of COVID-19 Vaccines – THE ANTISEPTIC, Vol. 118, No. 1, 2021
5. The Good and the Bad of Honey
TEA TIME
EXCERPTS FROM :
https://drtramaprasad.blogspot.com/2017/04/tea-coffee-and-commerce_30.html
https://www.thehindu.com/opinion/open-page/of-tea-coffee-and-commerce/article5567951.ece
Tea and coffee are the most common drinks across the world despite being branded as bad beverages by most of the doctors.
Doctors usually advise against the consumption of alcohol, tobacco, coffee and tea. But a patient asked me during consultation: “How many cups of tea should I give my kids each day?” Before I could comprehend what he was saying, he waved a copy of The Hindu(Oct. 10, 2013, Coimbatore edition), which quoted an official of the Tea Board as saying: “The benefits of tea on the health front should be widely propagated.” An office-bearer of an organisation was also quoted as saying that a series of meetings would be held with the help of the Tea Board to promote tea-drinking among children.
Claims
No doubt, tea leaves are generally and nutritionally good, like many other leaves we use in our diet, but the tall claims are commercially motivated. A little tea may be good, but it is unduly glorified by business. And now it seems it makes business sense to get children addicted to tea. They are already victims of irresistible commercial junk food that is unfit for human consumption.
There is no conclusive scientific evidence that tea, including ‘green tea’, reduces the risk of coronary artery disease, stroke, cancer or early death due to any cause. The U.S. National Cancer Institute “does not recommend for or against the use of tea to reduce the risk of any type of cancer.”
Dissemination of imbalanced information does more harm than good. And if a little tea is good, more of it need necessarily not be better. So, take the Tea Board’s words with a pinch of salt.
**************************************************************************************
The Conundrum of COVID-19 Vaccines
RAMA PRASAD T., VERSHA RAJEEV
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com
Ms. Versha Rajeev,
Freelance Medical Journalist, 74, Kalliampudur Road, Perundurai, Erode District, Tamil Nadu – 638052
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 118 No. 1 JANUARY 2021 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
THE ANTISEPTIC A MONTHLY JOURNAL OF MEDICINE & SURGERY
Vol 118, No 1, CONTENTS JANUARY 2021
EDITORIAL --
Parkinson Disease .........................................................................................................07
GENERAL
E Pharmacy: boon or evil? Mahesh Kumar Jain, Vijay Thawani......................................................08
The Conundrum of COVID-19 Vaccines Rama Prasad T., Versha Rajeev ..................................10
The Effectiveness of Back Massage in improving the quality of sleep among patients who
underwent Kidney Transplantation
Vijay Kumar Gauttam, Vishwakarma Nisha .................................18
Viral infections and their Preventive Methods
Sanjay Agrawal ...........................................................21
Compulsory licensing and orphan medicines
Rimjhim Sahu, Vijay Thawani ......................................25
ALTERNATIVE MEDICINE
Management of Kamala by Shamana Aushadhi : A Case Report Kaveri N.H., Aziz Arbar,
Mahadev P. Mangane, Veena K.H. ..............................................................................................................27
Medico Legal tips for doctors Sachin Chaudhary ...............................................................................29
Ayurveda and Asthama
Swapnil K. Tahasildar, Ashok Patil ..................................................................31
Role of Manas Chikitsa in the management of “Grahanivyadhi”
Satgonda Babgonda Patil ..............34
Ayurveda v/s COVID-19
Nikita Khetwal, Joshi S.K., Vimal Kumar, Sourmi ..............................................36
Nigella sativa and Honey may beat the coronavirus
Nita Sharma Das .................................................40
Sahyog Yogic Score: A tool for assessment of progress in Yoga Sadhaka
Prasad Sanagar
Occasional Review .........................................................................................................................................46
Gleanings ........................................................................................................................................................47
Glimpse into history ……………………………………………………………..……………………………………48
Case of the month; Medi Quiz; ......................................................................................................49 – 50
The Conundrum of COVID-19 Vaccines
RAMA PRASAD T., VERSHA RAJEEV
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com
Ms. Versha Rajeev,
Freelance Medical Journalist, 74, Kalliampudur Road, Perundurai, Erode District, Tamil Nadu – 638052
Specially Contributed to “The Antiseptic” Vol. 118, No. 1, P : 10 – 17, January 2021
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Abstract
Worldwide, at the moment, ‘COVID-19 vaccines’ is the subject of a spirited debate – about efficacy, safety and hurry. The unprecedented “pandemic speed” with which the researchers worked and the UK and some other countries approved the vaccines is phenomenal. Occurrence of some side effects squirmed the promoters and regulators in their seats. All these issues of the vaccines are outlined and commented upon in this article. Some current information about the vaccines of the enigmatic microbe is also presented, including the options and compulsions for India and the world. The hopes, controversies and possible disappointments are highlighted. Some contentious issues and matters of concern which may impact the public mindset connected with these vaccines are briefly touched upon. It’s only ‘the long and the short’ of them – not a detailed account. The jury is still out on vaccines for COVID-19.
Key words: COVID-19 vaccines, Vaccine nationalism, Vaccine regulations, Covid vaccine controversies, Coronavirus prevention.
Like the Colossus of Rhodes, SARS-CoV-2 is colossal in impact, and, in a way, both are related to the Sun. Coronavirus derives its name from its physical resemblance to the corona around the Sun, and the Colossus is the Greek Sun God, Helios whose humongous 105-feet-high bronze statue stood in the ancient Greek city of Rhodes. The statue was broken down to pieces and ‘eradicated’ by the Arabian empire in 654 CE. In the same way, can we eradicate this 0.125-microns-sized ‘tiny colossus’ by vaccines ?
Introduction
Not just a milestone, a historical milestone in the world of vaccines – the jab of a vaccine for COVID-19 on December 8, 2020 which is not a mere event of serendipity. A 90-year-old grandmother, Margaret Keenan, was the first person in the Western world to receive an approved vaccine (Pfizer-BioNTech) against COVID-19, at the start of a marathon campaign in the UK, after imposing the most onerous restrictions in Britain’s peacetime history. This heralds a fight-back against the pandemic which is pegged to cost the global economy a whopping $ 11 trillion. Corona vaccination is one of the most anticipated events in the history of COVID-19. It takes a lot to make a splash in the world of vaccines. Making vaccines for COVID-19 has become an urgent imperative as all the other available tools couldn’t contain it even in a time span of one year. The failures catalyzed a call for the researchers to race at a jet-speed to make effective and safe vaccines. They have been fast-tracking, even brushing aside the conventional regulations and norms in research, justified by the emergency generated by the raging pandemic. But given the high stakes, this is a counterpoint to science, albeit unconventional. A single misstep could cost thousands of lives. The topic of approvals of COVID-19 vaccines today is like a ‘hot potato’.
Viral speed
With the “corona speed”, a vaccine for COVID-19 has arrived, aided by the ‘rolling reviews’ by regulators and acceleration of approvals. This is the first time an ‘mRNA’ vaccine has been authorized for human use. This vaccine took just 10 months instead of the usual 10 years – yes, it took 9 years for the measles vaccine and 20 years for the polio vaccine. Subsequent to the Britain’s initiative, ‘greenlighting’ for vaccine approvals is likely to go at warp speed. Already, Bahrain, Canada, Saudi Arabia, Mexico, the US and Singapore quickly approved the ‘Pfizer vaccine’. The world’s first approval for Moderna’s vaccine emergency use was made by the US on December 18. America initiated vaccination on December 14, 2020 with ‘Pfizer vaccine’. Amazing metamorphosis of vaccine regulations ! Igniting excitement, this has infused a great relief to the traumatized and terrified world which has been huddled in isolation and lockdowns for about one year. Dampening this jubilation, has arrived towards the end of December 2020, with 70% more viral speed, the new UK variant (VOC 202012/01) !!! This has ‘locked down’ the UK again, this time more strictly, and even jeopardized the visit of Boris Johnson as the Chief Guest at the Republic Day parade of India.
Desolate scenario
An unremittingly grim year has passed by since the novel coronavirus made an entry into human dwellings, inflicting a sledgehammer blow. The grim figures stare at us -- 68 million cases and 1.5 million deaths, loss of $ 11 trillion, globally, as of December 2020. There has been a steep increase in the deaths in December 2020 -- more than 10,000 people in the world are dying each day due to second and third waves. One death every 30 seconds has been reported in the US which brags about its de la crème de status of healthcare on the planet, and its 15-trillion economy. In the worst-hit US, 3,000 people died in a single day on December 9, 2020 ! And 300,000 people died in the US so far. One year into the pandemic, lockdowns are being re-imposed. Our strategy to contain the virus is kaput. Our claim to have the capability to wipe out the virus is a chimera, as Corona is still breathing out fire like that of the mythological monster, Chimera.
The known unknown
Notwithstanding the tremendous strides that the science and technology have made, we are still groping in the dark corridors of COVID-19 vaccines, and witnessing macabre and grisly ravages of COVID-19. It is known that avaccinated person may be immune, but may be infective … for certain, it’s unknown yet. How long the immunity conferred by the vaccine would last, and at what threshold ? How safe is it ? Like this, there are several contentious issues and unanswered questions in the COVID- 19 vaccines arena. Covid vaccine controversies are aplenty. The governments need to clear the fog on vaccine safety and efficacy while beefing up the vaccination drive. Added to all this is the emergence of ‘variants’ and ‘mutants’ (VUI-202012/01, N501Y, 501.V2, B.1.1.7) in the UK, South Africa, Nigeria, etc. Will the vaccines that are rolling out would act against the variants ? Which is a better vaccine among the available ones ? Should the ‘recovered’ persons be vaccinated ?
Social vaccine vs pharmaceutical vaccine
When the “social vaccine” (social distancing, face masks and hand hygiene) didn’t yield the desired results, perhaps because of the size of our population and their ‘cheek-by-jowl’ existence in urban areas. It’s unfathomable that even the well-developed countries failed. With vaccines at our doorstep, this is the redemption time. The only way out for us is to use the “pharmaceutical vaccine” also. ‘Also’, because the ‘social vaccine’ is the foundation. This is an indubitable truth. Viewing vaccines as a magic bullet is fraught with danger. Relying only on ‘not-fully-tested vaccines’, as of now, may have catastrophic consequences. Clinical trials are done mostly on healthy volunteers, and hence the results can’t absolutely be extrapolated to all the groups.
A ray of hope
Scientists around the world have been working around the clock with Herculean effort to find an ideal vaccine against SARS-CoV-2 , the virus that causes the COVID-19 disease, to contain the world-ravaging pandemic. It seems that the vaccines would set right the world to get back to some semblance of normality, and to resurrect the drastically upended global economy. Claims of around 95% “success” are making rounds about ‘Covid vaccines’ by various manufacturers – Pfizer, Moderna, AstraZenica, etc. This has brought some cheer in an otherwise desolate scenario. It is expected that the advent of vaccines would turn the tide in the global war against the virus. Never in the history of vaccines was there such a globally-wide and prolonged debate among researchers, medical professionals, drug manufacturers, drug control authorities, the public and even the politicians about a vaccine as of now about that of COVID-19.
Modern vaccines
In those ‘good old’ days, it took 20 years to make the polio vaccine and nine years for the measles vaccine. Now, with advanced technology, it took just 42 days to make a COVID-19 vaccine. But the mandatory processes of trials and approvals take a lot of time. In the new ‘Messenger RNA (mRNA) technology platform’ there is no need even to get the actual virus. Once the genetic code is identified, a synthetic mRNA is made which can order cells to make the coronavirus protein which can induce antibody production without exposing the body to the virus. This takes little time. But the ‘testing’ and ’approvals’ may take a very long time, though. ‘Pfizer’ and ‘Moderna’ used this platform. Another platform uses ‘Modular Vaccine Concept’. Here, the coronavirus’s ‘spike protein’ is encased in a readymade-lab-made ‘adenovirus’ which may not take more than 90 days. ‘Oxford-AstraZeneca’ used this technology.
False sense of security
At the outset, it may be relevant to have an idea of the limitations of COVID-19 vaccination. A tremendous media hype has been going on, praising the “success” of the vaccines, when the UK became the first country in the West to approve a vaccine for use from December 2020. The jubilation made the “covid-fatigued” people think that the arrival of the vaccine marks the end of the ‘corona problem’ and the ‘unbearable’ advisories of coronavirus prevention. People would like to happily discard face masks as trash, shake hands warmly with all and hug emotionally all their dear and near ones. They don’t know that these vaccines are still in the “experimental” stage – “Emergency Use Authorisation” (EUA) -- with no hard and robust evidence of ‘long term efficacy and safety’. We are still not ‘out of the woods’.
Not only the doctors, even the researchers don’t know precisely how long the expected immunity conferred by the vaccines would persist – may be some weeks, may be some months or may be even more with booster doses. We don’t exactly know at this point of time. Vaccination is another preventive measure, not a replacement for the current advisories. Doctors and vaccinators should provide this information to the people they vaccinate. Otherwise, people may become complacent with a false sense of security of immunity in which case the vaccine may do more harm than good.
Making people aware of these facts and advising them not to let their guard down goes a long way to control the pandemic. Even the British Prime Minister Boris Johnson said in the Parliament, while referring to the introduction of the vaccine in Britain, that “people should not get too carried away.” The hubris associated with the vaccines may drive people into the ‘free pre-corona style of living’ which may only worsen the situation in winning over the seemingly invincible and insurmountable scourge, what with all the politico-medical ramifications associated with ‘individual freedom‘ and ‘vaccine nationalism’. The ‘pandemic-fatigued’ workers and people seem not to be sensitive anymore to the grim numbers of cases and fatalities.
Antagonism to vaccination
Imbalanced reporting by media has already set in the pessimism about COVID-19 vaccines – about those stray cases abroad and in India. The case in Chennai claiming a compensation of Rs. 5 crore for an alleged ‘serious side-effect’hit the headlines. But the causal relationship has not been established just as in the four cases of Bell’s palsy found in the vaccinated group of the ‘Pfizer-BioNTech vaccine’. On the first day of the “V-Day” of the Britain’s COVID-19 vaccination campaign, two National Health Service workers in the UK experienced ‘severe allergic reactions’ to the vaccine which is said to be ‘normal’ with vaccines in general. Two cases of ‘allergic reactions’ were noticed in Alaska also – one of them had severe ‘anaphylactic reaction’ with no history of allergy. Added to all this, is the genuine disconcerting doubt about lack of transparency and the undue haste to push through the vaccines across the world. Promoting an ineffective or unsafe vaccine is worse than not having one.
One should hope that the vaccination would not be opposed by some groups in the US and elsewhere, as it happened with the measles / MMR vaccine. A ‘Pew’ survey in the US showed that only 37% of the people are willing to be among the first to take the vaccine. It is reported that Queen Elizabeth II, 94 years, and her 99-year-old husband, Prince Philip, wish to publicize their being vaccinated against COVID-19 “as a powerful counter to the anti-vaccination movement” in the UK. The digital media have a tendency to amplify trivial adverse incidents and put them on a viral trajectory to be imbibed by individual minds.
Though the ‘anti-vaxxers’ are a minority, they are noisy ‘derailers’ through ‘social media’, and this noise drowns out anything less loud. So, ‘pro-vaxxers’ need to increase their decibels over the same media to counter.1 The needle of emotion swings wildly between whooping exultation and eye-rolling cynicism. WhatsApp is a notorious ‘superspreader’ of fake information at ‘super-viral’ speed. ‘Undue play up by media’ of some side-effects to vaccines which erodes citizens’ faith in the vaccines leading to ‘vaccine hesitancy’, as happened with some vaccines in the past, is a matter of concern.
That doctors are no exception can be seen in the report: “Officials at the district health department (Coimbatore) claimed that the doctors at the private hospitals are reluctant to register their names for the phase-one vaccination drive as they are doubtful about the vaccine and its success rate” (The New Indian Express, 09.12.2020). And, an online study by a consultant at Apollo Hospital, Chennai revealed that only 45% of the health professionals preferred to take the COVID-19 vaccine, and 10% said they will never take the vaccine. The rest are undecided (The Hindu, December 17, 2020). Some world leaders are also no exception. The Brazilian President Jair Bolsonaro launched an attack on coronavirus vaccines by saying that the vaccine could turn people into crocodiles; women into men; men into women ! (The Hindu, December 20, 2020). He said this on December 17, 2020 even while about to launch a vaccination campaign in his country. He blatantly dissed the programme.
Misinformation and distrust shouldn’t be allowed to undermine the highly credible work done by the hugely eminent scientists. Nothing in this world has zero side-effects. Even with the time-tested polio vaccine, about one in 2.5 million children gets polio from the ‘weakened’ virus present in the vaccine !
Vaccine Crime Networks
It may be a tad shocking to know about this. As COVID-19 vaccine has become a precious and crucial commodity, organized networks would do criminal activities connected to these vaccines with monetary and political motives. On December 2, 2020, Interpol has issued a global alert to law enforcement agencies of its 194 member countries, asking them to prepare themselves to face the targeting of COVID-19 vaccines. “The Interpol Orange Notice outlines potential criminal activity in relation to the falsification, theft and illegal advertising of COVID-19 and flu vaccines, with the pandemic having already triggered unprecedented opportunistic and predatory criminal behavior,”the Interpol said. People should be wary of fake / spurious vaccines and fake websites. Interpol Secretary General Jurgen Stock said: “Vaccines are the prime target of organized crime. As governments are preparing to roll out vaccines, criminal organizations are planning to infiltrate or disrupt supply chains.” It may even be possible to infiltrate enemy countries with spurious or toxic coronavirus vaccines.
The Good and the Bad
There has been an avalanche of information about these vaccines – true and false as well. Debates have been going on. It should be acknowledged that tremendous strides were made in making the vaccines in a very short period of time which may be the real remedy for this unending malady. The studies conducted so far showed excellent results. It would be wonderful if the same results can be seen in the long run of the studies. Past experience with other vaccines indicates that it can be. While an ‘ideal’ vaccine may wipe out the dreaded scourge, the limitations in achieving the ‘ideal’ may end up our expectations as delusions of grandeur. The downside of the assessment of the vaccines, at the time of writing this (December 2020), is the limited numbers of participants in the clinical trials, the fast-tracking of the protocols of research and the uncertainty of ‘long-term efficacy and safety’ which is of paramount importance. It may be an emergency evaluation with attendant flaws, commercial urge and political overtones. The leapfrogging may make the good appear dodgy.
Political pressures
The UK and some other countries had already approved vaccines, in December 2020, to be given to their citizens in December 2020. Britain’s breakneck speed drew criticism from Brussels where, in an unusually blunt statement, the European Union’s drugs regulator said that its longer procedure was more appropriate as it was based on more evidence and more checks. However, the Medicines and Healthcare products Regulatory Agency (MHRA) chief June Raine said in a televised briefing that ‘no corners have been cut’.” And, British and American officials sparred overthe appropriateness of the approval and the ‘vaccine nationalism’. Does this mean that the UK’s approval is rash and risky ? The head of the US National Institute of Allergy and Infectious Diseases, Anthony Fauci, said that the MHRA had ‘rushed through that approval’.
The world’s invisible enemy, causing the ominous and looming pandemic, has the largest collection of medico-political controversies. COVID-19 vaccines are unique in having the darkest political shade. The shade in countries like China and Russia is riddled with the doubts of transparency. In other countries, there has been a varying degree of overt and covert political influence. There has been the political and scientific urge to be the first – ‘vaccine nationalism’. Various countries have been racing to be the first. Dr. Balram Bhargava, Director-General of the Indian Council of Medical Research (ICMR), urged the researchers to make the Indian ‘Covaxin’ vaccine available by August 15, 2020 (Independence Day). Finally when it was approved four months later, it was alleged it was a nod by the Subject Expert Committee made under “pressure”. The committee had refused permission just a day earlier citing insufficient data ! It led to scientific criticism, barbs between heads of manufacturers and political joust – one even labelled the vaccine after a political party. All have been working in an unprecedented fashion, but to say that all are in this international initiative together is the greatest cliché.
Is the research directed by scientists or politicians ? Often, the scientific studies are dogged by political pressures. One quintessential example is this: “ … it was reported that the White House had threatened to fire Food and Drug Administration chief Stephen Hahn if he did not grant emergency approval (for Pfizer-BioNTech COVID-19 vaccine) on Friday (December 11, 2020) … “ (The Hindu, December 13, 2020). Dr. Asish Jha, dean of Brown University’s school of public health said that the political meddling would chip away the public confidence (The New Sunday Express, 13.12.2020). The recent poll (December 2020) by Associated Press – NORC Centre for Public Health Research indicated that “just half of the Americans say they want to get vaccinated, while about a quarter don’t and the rest are unsure.” President Donald Trump, making a U-turn, said that he and the senior White House staff members would delay the plan to receive the vaccine in the coming days. The novel coronavirus is the historical political virus. The sustained political ‘viral’ outbursts of the POTUS Donald Trump against China would resonate forever in the history of COVID-19.
There has been mounting criticism from the world medical community that regulatory authorities are bowing to political pressures. It is a global competition – academic, commercial and political as well. And, a ‘vaccine nationalism’ ! For instance, the hurried Russian vaccine ‘Sputnik V’ is like a Russian roulette. 200,000 were vaccinated. If it succeeds, it's a bounty, otherwise it's a disaster. China has already vaccinated over one million people. Who can regulate ? A spate of successes has been claimed. Who knows the truth ? Many of the decisions in this world-ravaging pandemic are based on best guesses and probability – Bayes’ theorem for probability.
The rat race
Pharma giants all around the world have been rushing through at a furious and frantic pace to make a vaccine 'immediately' ! About 50 candidate vaccines have been undergoing trials, based on four technology platforms. Around 30 candidates are in clinical evaluation stage. Over 100 studies are in various stages in about 500 clinical trials. They want to make it in 2020 itself. But it could be 2021, 2022, or never ! And, there is the money factor too – billions of dollars, government grants, private investment, profit expectations, etc.
Vaccines in the pipeline
1. ‘GERMAN–US’ vaccine: Pfizer-BioNTech; BNT162b2; New messenger RNA (mRNA) platform* - for spike protein; 90% efficacy; storage .. minus 70 degrees Celsius; Rs. 1,500 per dose; available in the UK & elsewhere from December 2020.
2. ‘US’ vaccine: Moderna; mRNA-1273 for spike protein; New messenger RNA (mRNA) platform*; 95% efficacy; storage .. minus 40 degrees Celsius; Rs. 2,775 per dose.
3. ‘British’ vaccine: Oxford-AstraZeneca; ChAdOx1 nCoV19 / Covishield; Traditional inactivated virus platform – Adenovirus from Chimpanzee; 70% efficacy; storage .. 2 to 8 degrees Celsius; Rs. 600 per dose; Supply prioritised to India; 10 crore doses by January 2021 ; Manufactured under license by Serum Institute of India; 500 million doses ordered by India; 40 million doses ready under the ‘risk-manufacturing license’.
4. ‘Russian’ vaccine: Gamaleya Institute; Sputnik V; Two human adenoviruses vector platforms; 95% efficacy; Free of cost for Russians; Partnered by Dr. Reddy’s Laboratories, Hyderabad; Likely to be available in India by December 2020; 100 million doses ordered by India. A prediction of protection up to 2 years is reported
5. ‘Chinese’ vaccines: Sinovac Biotech – 1 vaccine; Coronavac; Adenovirus platform; Sinopharm – 2 vaccines; 86% efficacy.
6. ‘Indian’ vaccine: Bharat Biotech, Hyderabad / ICMR’s National Institute of Virology, Pune; Covaxin; Traditional whole cell inactivated virus platform, fully locally developed from a strain isolated by ICMR-NIV, Pune; Likely to be available by June 2021 / earlier.
7. ‘Indian’ vaccine: Zydus Cadila, Ahmedabad; ZyCov-D; World’s first Molecular Plasmid DNA vaccine / Live measles viral strain platform; Likely to be available by March 2021.
8. ‘Indian’ vaccine: US-based Novavax / SII of Pune; Recombinant nanoparticle platform; Likely to be available by March 2021; one billion doses ordered by India.
9. ‘Indian’ vaccine: Genova Biopharmaceuticals, Pune / US-based HDT Biotech Corporation; India’s first m-RNA platform; Permitted on 10.12.2020 to do ‘human trials’. Storage temperature 2-8 Degrees Celsius
10. Other vaccines that are in the making: (1) Biological E (Hyderabad) a protein sub-unit vaccine, Corbevax, similar to Novavax/ Baylor College of Medicine; Dynavax; Ad26, COV2.s Adenovirus. (2) Mynva IISc, Bangaore; Mynvax ; Heat-tolerant vaccine; Likely to be available by March 2021. (3) Nasal vaccines under development; Produce local IgA antibodies to block the virus at the entry point in the nose. To be instilled through nose. (4) Johnson & Johnson; single dose
* mRNA platform technology was never approved before for vaccination in human beings. The non-replicating viral vector vaccines are safer than live or replicating vaccines. There is a study planned to test a mix of Oxford-AstraZeneca and Pfizer-BioNTech platforms. Yoking nascent technologies needs a deep study.
On December 2, 2020, there was an announcement that the UK approved ‘Pfizer-BioNTech COVID-19 vaccine’, and the vaccine rolled out on December 8, 2020. Thus, jumping ahead of the US, the UK was the first country in the West to start public vaccination for citizens. Some other countries followed suit. China started vaccinating its population with its vaccines earlier, and vaccinated over a million. And, Russia started vaccinating at-risk workers on December 5, 2020. The main purpose of these vaccines is to prevent serious disease, hospitalisation and death.
The vaccines are given in two doses separated by 3 to 4 weeks. Protection starts 10 days after the second dose. Given to people above the age of 18 years. Pregnancy and alcohol are to be avoided around the period of vaccination.
Vaccines for INDIA
COVID-19 Vaccines are very important for India as it can’t afford further lockdowns. Any amount of money spent on the vaccine is money well spent. It will speed up an economic rebound and pay back. Richer countries have already booked vaccines by paying upfront. India has also done its job well by making advance market commitment for 1.6 billion doses (Oxford – 500 million; Novavax – 1 billion; Gamaleya – 100 million), more than any other country.
There are two costly mRNA vaccines from Pfizer and Moderna which require ultra-cool (minus 40 to minus 70 Celsius) storage conditions. As such, they may not be suitable for India as we lack the infrastructure to store and distribute them at such sub-zero temperatures, even if we can afford the high cost. From the cost, storage and availability point of view, we may have three choices out of the eight that are being developed or partnered in India -- 1. Sputnik V of Gamaleya Institute of Russia. 2. Covishield of Oxford-AstraZeneca of India. 3. Covaxin of Bharat Biotech of India. India has a broad blue-print ready to vaccinate 30 crore high-risk individuals within the first half of 2021 with these three vaccines. In the 2nd phase, 80 crore (60% of the population) people are planned to be vaccinated.
As there may be only a limited production capacity initially, given the circumstances, we may have to source vaccines from multiple companies from around the world and course through various pathways. Prioritisation of the beneficiaries of free or subsidised supply should be made urgently to have maximum benefit and equitable distribution. As of December 15, 2020, it seems that from early 2021 onwards 30 crore Indians -- front-line workers (2 crore), health-care workers (1 crore), police personnel, those vulnerable due to underlying illnesses, senior citizens, etc. (27 crore) -- would receive the vaccine, to start with. The National Expert Committee on Vaccine Administration for Covid-19 is actively, but cautiously, deliberating on this issue, calling for more evidence from the manufacturers, which is likely to delay the approval. And the drug regulator of India, Drug Controller General of India (DCGI) started ‘rolling reviews’ to facilitate approval in December 2020 itself, though the Indian Medical Association (IMA) sounded a caution, and the president of the IMA of Maharashtra said that emergency approvals for the vaccine have more disadvantages than advantages. The health and economic exigencies are rightly compelling accelerated approvals forpublic good. The first choice of vaccine for India would be of those that roll out from companies based in India, in view of advantages of availability, storage and cost. The expensive vaccines may be permitted to be imported into the open market, as India has rich people also who would like to have the best at any cost. The less expensive vaccines to be used by the government may be allowed into private market system to lessen malfeasance in the subsidised public sector distribution chain.
Last, but not the least, is the task of channelizing the procured vaccine by the government. The available ‘cold chain’ in our national Universal Immunisation Programme (UIP), which is already handling more than 30 million cases of children and pregnant women, may be sufficient for the three front-running vaccines for India – Sputnik V, Covishield and Covaxin. As per the 113-page “Covid-19 Vaccines Operational Guidelines” sent to States, the Covid Vaccine Intelligence Network (Co-WIN) system – a digitalised platform – will be used to track enlisted beneficiaries for the vaccination on a real-time basis. This is an upgraded version of the Electronic Vaccine Intelligence Network (eVIN) to tag and track the vaccines. All the same, there may be a design, logistics and implementation challenge with the 2-dose vaccine. There are other issues to be decided urgently – stratifying eligible people by categorising according to risk and according to ‘infected’ status which is to be determined by records of infection or identifying by ‘antibody’ / ‘T-cell immunity’ tests. There are a host of other contingencies connected with proper administration and meticulous planning. Unless these are attended to well before the expected arrival of the vaccines, there would be a needless chaos and waste of the vaccine. ‘Vaccine hesitancy’ might become a monstrous problem unless tackled very tactfully, especially in view of the media publicity of ‘rushing through the trials and approvals’ and amplification of side-effects.
Unfortunately, the confusion is confounded by the divergent views expressed by different dignitaries in India, over ‘priority sequence’ for various groups, cost-free distribution, etc. Blissfully, Tamil Nadu, Bihar and some other States promised to budget for ‘cost-free’ vaccination. If a shot costs Rs. 1,000 and all the 130 crores of Indians are to be given two doses, it would cost Rs. 2.6 lakh crore. But the whole population need not be given. Whatever it is, the government should not think twice to foot the bill, considering the huge benefits for national economy, if the vaccine really works. It is high time that a comprehensive vaccination policy at the national level is established with clear enunciation of scientific rationale. The government’s policy of vaccinating a ‘critical mass of people’ to ‘break the chain of transmission’ is riddled with challenges, especially due to the peculiar character of ‘uneven transmission’of SARS-CoV-2. Unless 70% of the population is covered, ‘herd immunity’ can’t be expected. ‘Universal vaccination’ is desirable. To clear some confusion, on December 1, 2020, the Union Health Secretary clarified that “the government has never spoken about vaccinating the entire country”, in the context of an earlier statement of the intention to vaccinate all (universal vaccination). There might be some sound compulsions to shy away from the previous stand. Vacillation in vaccination plans may end up in an apotheosis of terminal decadence of ‘corona control strategy’.
Vaccination and immunity
SARS-CoV-2 is different in immunological aspect also. We have two types of immunity – ‘innate’ (inherent) and ‘adaptive’. The adaptive immunity has two components -- ‘antibodies’ and ‘T-cell immunity. Vaccination or infection produces antibodies and T-cell immunity. But in the case of COVID-19 vaccination or infection, the antibodies may be present only for a couple of months while the T-cell immunity may be durable for six months or more. When a vaccination policy is made not to vaccinate people who have immunity due to previous infection with or without symptoms, tests must be done to detect T-cell immunity rather than the antibodies (antibody tests are being done now), to identify this group of population. But this test is very complicated and very costly. Cardiff University researchers have now come up with a simplified, cheaper and rapid T-cell immunity test called “T- SPOT test”. 2,3 And, people who were infected by other viruses (common cold viruses, etc. – very common in India) may have T-cell immunity which acts against SARS-CoV-2 virus also (pre-existing / cross-reactive - memory T-cell immunity). This may be the reason for lesser health damage in India due to the novel coronavirus. Also, BCG vaccination may have benefitted.
Vaccination in recovered / reinfection cases
Concern is expressed about the reported cases of reinfection with mild or no symptoms, but which may be infective. The ‘reinfected’ cases had only mild symptoms. As suggested by observations and by a ‘macaque model’, reinfection seems to be very rare (globally, around 10 documented cases only, out of 47 million ‘recovered’ cases), despite more than eight months of circulation of the virus worldwide. The immunity offered by the natural infection probably lasts for a long term by virtue of T-cell immunity even when antibodies may not be detectable any more. This means that absence of antibodies does not mean lack of immunity or absence of evidence of previous infection. Perhaps, the ‘recovered’ cases may gain more immunity even with one dose of the vaccine, going by the results of the serendipitous ‘half-dose-accident’ of the Oxford vaccine trial. The implications are yet to be known. Vaccination may confer better immunity than natural infection.
Privilege and profiteering
During this human tragedy, it is a crime, a shame, and a scandal to make a profit out of a disaster. Unfortunately, the international vaccine market is poised to make a fast buck. Advance purchase agreements were already made with some rich countries. This deprives the chance of survival of poor countries from the onslaught of COVID-19. The WHO chief said on December 4, 2020: ”Rich and powerful nations must not trample the poor and marginalized in the stampede for vaccines.” Such profiteering and ‘vaccine nationalism’ can be countered by bodies like Global Alliance for Vaccine Initiative (GAVI), World Trade Organisation (WTO), Trade-Related Aspects of Intellectual Property Rights (TRIPS), World Health Organization (WHO), Corporate Social Responsibility Fund, etc. This gains importance as, firstly, the world is not safe even if one country breeds the virus. Secondly, the emerging vaccine is not yet proved to be fully effective and safe in the long run. Thirdly, the vaccine alone is not a panacea to eradicate the virus.
On a larger canvas, to contain the ‘Corona’, it is imperative that all the countries, research institutes and the ‘big pharma’ should pool contributions for “public good and public safety”, and equitably distribute the ‘covid vaccine’ free of cost to all who need across the globe. This is not the time either to play politics or to make money out of a crisis. At least, the WTO can wield influence on member-nations to forego trade profits on this vaccine for a humanitarian cause.
Haste is a waste
Manufacturers are jostling to prematurely announce vaccine results. It is a matter of concern that hasty, unsubstantiated and opaque claims have been circulating about the efficacy and safety of the vaccines made by various manufacturers. Some say 70%, some 90%, some 95% and so on. Covid controversies have become commonplace. For example, there is a palpable unease among scientists about the unexplained differences in doses given and the percentages of efficacy – 90% with half dose and 62% with full dose -- of the ‘Oxford-AstraZeneca vaccine’ had left scientists intrigued. Faux pas ? The research snafu was acknowledged as an ‘error’. Experts said the ‘error’ and a series of other irregularities and omissions which came to light have eroded confidence. A sober reflection would only lead to the ineluctable conclusion that haste is a waste, casting shadows on the transparency and credibility of research. While the emergency is justified, the hurry betrays a competitive, market-centric streak. The greedy haste only makes the public suspicious of vaccination benefits which would be counterproductive. It generates ‘vaccine hesitancy’. It is possible that a lower dose of the first injection of a two-injection-vaccine may confer better immunity called “prime boost immunity”, but in this case, it was not planned that way. If this is proved to be fruitful, this serendipitous ‘lucky accident of science lore’ should be thanked for.
Of course, there is the urge to fast-track, as the global economy is on the verge of collapse. And, the lure of speed of entry to make a fast profit often puts quality concerns on the margin. The race is against time. The traditional race for a vaccine is more of a marathon than a sprint, based on scientifically rigorous and highly ethical research. But now, it’s an emergency, with inevitable shortcuts. One needs to have trust in the jabs despite the blips. That's the reality – reality of being a Schrodinger’s cat which is both ALIVE and DEAD ! A lot more is to be done, as the vaccines that are being approved are not “fully” studied and may not be “ideal”. Of course, we would be lucky to have them, if they are proved to be ideal in the long-term studies.
Unpalatable facts
Trust is of paramount importance in any vaccination programme. There has been a sensational media coverage on the alleged “Severe Adverse Event” (SAE), due to ‘Covishield’ vaccine (Oxford-AstraZeneca), suffered by a Chennai-based volunteer of the study trial who sought monetary compensation to the tune of Rs. 5 crore and stopping of the trial in a legal notice to the Pune-based Serum Institute of India (SII). Subsequently, the SII stated that the claim was “malicious” and that it will seek damages in excess of Rs. 100 crore for damaging the reputation of the company. Consequent to this, several bioethicists and scientists, including Dr. Amar Jesani, editor of the Indian Journal of Medical Ethics and Dr. Jacob John, a well-known virologist expressed shock at the SII’s threatening and bullying the trial volunteer. It was said that this was an act of lack of professionalism in managing a vaccine trial, and that this may discourage volunteers to participate, and make the public reluctant to accept the vaccine. Following the furore over the incident, the government said on December 1, 2020 that the adverse event did not necessitate stoppage of the trial and has not impacted time-lines for the vaccine’s rollout, as the event was not linked to the vaccine. Nevertheless, this highly publicized event may make the common man hesitant to take the vaccine, just as it happened with some other vaccines in the past.
Aberrant and formidable virus
The SARS-CoV-2 virus that causes COVID-19 disease is distinctly a cause for global concern owing to its unusual characteristics which may have an issue with vaccines against it. This virus is different from all the other known coronaviruses and hence is the unpredictability of finding a highly effective and absolutely safe vaccine. Unlike most of the other viruses, this virus presumably started as an agent of ‘zoonosis’ (transmission from animals to humans – in this case it is likely to be a bat) and accelerated fast into the mode of ‘anthroponosis’ (transmission from person to person). The most alarming aspect is that an apparently normal person may infect others, days before that person develops symptoms of COVID-19. In the case of most other infections, persons become sick before being capable of transmitting the microbe, thus making us know of the infectivity to break the chain of transmission. And, it spreads very fast and speedily kills many, despite good treatment.
Though the mode and spread of SARS-CoV-2 resembles influenza viruses, the dramatic kill power perplexed all. Often, pandemic-causing-viruses are replaced by less virulent viruses. The A H1N1 of 2009 was replaced by H2N2 in 1957, which was then replaced by the H3N2 virus of the pandemic of 1968. But the H1N1 virus of the pandemic of 2009 did not replace H3N2. Since then, both of them have become endemic globally. They may persist until another influenza virus replaces them. Owing to its aberrant nature, the highly virulent SARS-CoV-2 virus may most likely emerge and persist globally as an epidemic, unless a low-virulent beta coronavirus replaces it, or an ideal vaccine is made.4 And, the different profile of SARS-CoV-2 makes the success of the vaccine unpredictable, especially after the emergence of the NEW variants / escape mutants (VUI-2020/12/01, N501Y, 501.V2, B.1.1.7) in Britain, South Africa, Nigeria, etc. The UK variant was found to be 70% more infectious than the original Covid strain. A single mutation – N501Y – has been found to be more transmissible due to its increased binding affinity for the ACE2 receptor. VUI-202012/01 variant has 23 mutations in all. As of December 2020, 19 variants were found in India out of the 86 worldwide (CSIR – Institute of Genomics and Integrative Research, Delhi), and at least seven UK returnees in India, including a 2-year-old girl, were found to be carrying the UK variant. A matter of concern, though not to be alarmed about, is that these variants with genetic changes may be resistant to antibodies. All vaccines are to generate antibodies against the spike protein of the virus to block the entry of the virus into human cells. As of now (December 2020), the thinking is that the presently available vaccines are most likely to be effective against the variants too. If not, new vaccines are to be made embedding a technic called ‘tweaking’.
Perpetual fear
When this virus settles down as an endemic, the vulnerable segments of the population -- those with co-morbidities like diabetes, chronic lung and heart diseases, and the senior citizens -- would live in a perpetual state of fear of unexpected death, as finding a really effective anti-viral drug is a long shot. Another fear is about the possibility of extra-human reservoir of the virus, through reverse transmission from humans to animals. COVID-19 is already reported in some pet canines and felines. The virus is also found in faeces and in sewage. With the introduction of COVID-19 vaccine, this worried segment of the population may have more peace and sleep.
Blessing in disguise ?
Non-pharmaceutical interventions (NPI - hand hygiene, facial masks and physical distancing) implemented to cut down the transmission did not yield the desired results, perhaps due to human failure to comply with the ‘preventive advisory’ – even some doctors hang their used masks and hospital coats inside their homes for reuse. In a lighter vein, they call these masks as ‘vaccines’ as they may produce ‘subclinical (asymptomatic or mild) infection’ among family members conferring immunity ! In fact, seriously speaking, according to ‘variolation theory’, masks provide ‘subclinical infection’ which results in strong cell-mediated immunity.5,6 This is a pleasant scientific surprise. In some medical centres, protocols of prevention are not followed strictly for various reasons. Elective procedures and surgeries are done without ‘testing’. Under these circumstances, the vaccine seems to be the ray of a huge hope.
Wishful thinking
We may wishfully think that SARS-CoV-2 may die out naturally as happened with some viruses or that it may be replaced by a low-virulent virus, but to sleep over the matter on this presumption would be foolish. Hence, the fear persists until an ideal vaccine is in the market. If truth be told, there is no IDEAL vaccine on the horizon yet – an ideal vaccine has to meet with a lot of qualifications which are extremely difficult to achieve. But we can. Think positively. Think about our ‘Indian’ Covaxin. Apart from the advantages of cost, storage temperature and availability, the ‘desi’ Covaxin’ may act better on the new mutant variants of the virus that are coming up, because this vaccine is made on the ‘Traditional Whole Cell Inactivated Virus Platform’. Smallpox is deadlier than COVID-19. Saiban Bibi was the India’s last smallpox case in 1975, and in 1980, the world eradicated smallpox through vaccination.
In an address to the UN General Assembly, Tedros Adhanom Ghebreyesus, Director-General of the WHO, said (December 4, 2020) : “The positive results from coronavirus vaccine trials mean the world can begin to dream about the end of the pandemic, but a vaccine will not address the vulnerabilities that lie at its root … while the virus can be stopped, the path ahead remains treacherous.” Hence, while one big hurdle is crossed, the war is far from over.
We still don’t know when an ideal vaccine will be available, though SOME vaccines may be available soon in India which showed promising results in ‘preliminary clinical trials’. The consolation is that even if a vaccine of 70% efficacy is given to 70% of a prioritized population, the resulting “herd immunity” coupled with “herd effect” (decreased disease in unvaccinated population) would achieve “control” (deliberate reduction of disease frequency to a desired level), as inoculating a ‘critical mass’ of people might be enough to break the ‘chain of viral transmission’. Subsequently, “elimination” in every country would lead to “eradication” at a global level which is the ultimate objective of a successful global vaccination programme. Until then, we may have to live a horrible life hiding behind the face masks !!!
REFERENCES
1. https://science.thewire.in/health/covid-19-anti-vaccination/
2. https://www.cardiff.ac.uk/research/explore/research-units/t-cell-immunity-group
3. https://www.cardiff.ac.uk/news/view/2425277-quest-for-covid-19-t-cell-blood-test
4. John TJ. Will coronavirus pandemic eventually evolve as pan-endemic? Current Science. 2020;118(6):855-6. Available from: https://www.scopus.com/record/display.uri?eid=2 -s2.0- 85085976260&origin=inward&txGid=e1083edc3 cb277e3b8a1bcdfbcca8e84
5. Sekine T, Perez-Potti A, Rivera-Ballesteros O, et al. Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19. Cell 2020 August 11 (Epub ahead of print). Google Scholar5.
6. https://www.nejm.org/doi/full/10.1056/NEJMp2026913 ..
The tectonic developments in COVID-19 vaccines may make one feel that the vaccination puts an end to the pandemic. But it’s not so. It is not the ‘be-all and end-all’. Don’t let your guard down.
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
The Hindu (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. DIGITAL CLUBBING and HYPERTROPHIC PULMONARY OSTEOARTHROPATHY - Pathogenesis --
The Antiseptic, Vol. 76. pp. 213-215, 1979.
2. CHILDHOOD TUBERCULOSIS - Part I -- The Antiseptic, Vol. 76, pp. 449 - 504, 1979
3. CHILDHOOD TUBERCULOSIS - Part II -- The Antiseptic, Vol. 76, pp. 567 - 574, 1979
4. STEVENS-JOHNSON SYNDROME and THIOACETAZONE -- The Antiseptic, Vol. 77, pp. 99 -102, 1980
5. HIGHLY PURIFIED INSULINS - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
7. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
9. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
10. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 --
……http://www.thehindu.com/opinion/open page/article2801701.ece
11. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012 --
...http://www.thehindu.com/opinion/open-page/article3340116.ece
12. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 --
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
13. A BAD PATCH - The Hindu, Open Page, March 15, 2020 --
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
14. YELLOW NAIL SYNDROME - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
15. YELLOW NAIL SYNDROME - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
16. DRUG RESISTANCE in TUBERCULOSIS - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
A short list of some of the published articles authored / co-authored by Versha Rajeev:
1. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
2. Antiseptics, Disinfectants and COVID-19 – THE ANTISEPTIC, Vol. 117,
No. 11, pp. 26 – 28, 2020
3. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
4. The Conundrum of COVID-19 Vaccines – THE ANTISEPTIC, Vol. 118, No. 1, 2021
5. The Good and the Bad of Honey
The story after the publication of this article:
Two vaccines were approved for “emergency use” in India and the world’s largest vaccination drive was started on January 16, 2021. The two vaccines are: 1. Pune-based Serum Institute of India’s ‘Covishield’ and 2. Hyderabad-based Bharat Biotech’s ‘Covaxin’. The former has been tested for safety and efficacy in participants from both within and outside India. The later, ‘Covaxin’, is based only on Phase 1 and 2 trials as of January 2021. It was alleged it was a nod by the Subject Expert Committee made under “pressure” to approve ‘Covaxin’. The committee had refused permission just a day earlier citing insufficient data ! It led to scientific criticism, barbs between heads of manufacturers and political joust – one even labelled the vaccine after a political party.
Days after the start of the inoculation programme, manufacturers of both the vaccines issued ‘warnings’ about the use of these two vaccines which led to discussions, debates and ’vaccine hesitancy’.
Three vaccines were approved abroad for use in western countries: 1. Pfizer 2. Moderna 3. AstraZeneca. Some deaths in the very elderly were reported after receiving ‘Pfizer’ vaccine in Norway and Germany which led to issuing of an advisory not to use the vaccine in people aged above 80 in Norway.
“COVID-19 VACCINE DEATHS in Norway and Germany prompted me to write this in THE HINDU of January 18, 2021. About 40 people died after the vaccination. Most of them are aged around 80 and had some preexisting serious health problems, but these factors alone can't easily explain away the deaths. Hence, all the countries are to be wary of adverse consequences while vaccinating elderly population. Some information on COVID-19 vaccines may be found in the attached PDF.” -- Dr. T. Rama Prasad, Perundurai, India.
“THE CAUTIONARY issued by the manufacturer of the 'Covaxin' vaccine states that it should not be taken by people having allergy, fever, poor immunity, blood thinners (aspirin, etc.), bleeding disorders, etcetera (Page 1, THE HINDU, January 19). Notifying important contraindications after the launch of the product does not seem to augur well. Does this apply to the other vaccine 'Covishield' ? How does one know that he is having 'poor immunity' ? Medication that affects the immune system (immunosuppressants, steroids, etc.) is also listed as a contraindication, though it was stated otherwise earlier by authorities. It is important to clarify and avoid confusion in the public mind which might be in a state of 'vaccine hesitancy'.
Close on the heels of the cautionary issued about 'Covaxin', a warning is issued not to take 'Covishield' if one is allergic to "L-Histidine, L-Histidine hydrochloride monohydrate, Magnesium chloride hexahydrate, polysorbate 80, Ethanol, Sucrose, Sodium chloride, Disodium edetate dihydrate (EDTA), Water for injection" (sic) (Page 12, THE HINDU, January 20). How does anyone know about allergy status to the myriad of ingredients ( including 'water for injection' !) in the vaccine ? This sort of over-protective (for the manufacturers) notifications might only undermine the public confidence. These notifications seem to be acts aimed to legally protect the manufacturers as the government declared that it can't be held responsible for any side effects. A vaccine volunteer earlier sued a company for a compensation of five crore rupees.” -- Dr. T. Rama Prasad, Perundurai, India.
AstraZenica company had withdrawn in 2024 its COVID vaccine Vaxzevria ( named as Covishield in India). The company admitted in a court in the UK that its vaccine may cause side-effects including 'Thrombosis with Thrombocytopenia Syndrome' which might have caused deaths. The company is facing a 'Class-action' lawsuit in the UK. Fifty one cases have been filed against the company.
—--------------------------------
Dr. T. Rama Prasad wrote this article which was published in
The Antiseptic, a monthly Journal of Medicine and Surgery,
of November 2023 - Indexed in IndMED www.theantiseptic.in Vol.120,No.11
Over-prevention, Over-investigation, Over-diagnosis and Over-treatment
Author : Dr. T. Rama Prasad
.-----------------------------------------------------------------------------------------------------------------
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu, India
Presently: Director of ‘PAY WHAT YOU CAN CLINIC’, Perundurai, Erode District, Tamil Nadu – 638052, India.
Specially Contributed to “The Antiseptic” (Medical Journal Indexed in IndMED) www.theantiseptic.in
“Science is always wrong. It never solves a problem without creating ten more.”
-- George Bernard Shaw
INTRODUCTION
The unrelenting spread of COVID-19 had set off a lot of ‘emergency’ and ‘experimental’ initiatives in ‘Modern Medicine’ (Allopathy) which is the most accepted scientific system of medicine all over the world. It has been based on a robust foundation of science, logic, rationale and wisdom. The rigid regulatory checks and balances of ‘normal times’ have become flexible and arbitrary in many countries during the Covid pandemic. Some pharmaceutical companies and some hospitals had taken advantage of this to promote certain drugs and vaccines for profiteering. Fear among the public paved the way for profiteers. It's a see-saw like situation with evidence for and against coupled with shifting advisories which had become commonplace. The phenomenon of ‘over-prevention, over-investigation, over-diagnosis and over-treatment’ which started around 1970s got tremendous traction during the Covid pandemic period. Some of the issues are brought to focus directly or indirectly in this article written in an informal way which may provoke thought and may even make some people squirm restlessly in their seats.
Over-investigation inevitably leads to over-diagnosis, and over-diagnosis has the disastrous consequence of over-treatment which includes death.
AMAZING ACHIEVEMENT
Vega, a medical student, asked me: “Doctor, why are these people awarded the Nobel Prize for developing the dangerous ‘mRNA COVID vaccines’ ?” My reply was: “It is a monumental work of decades which enabled timely manufacture of an effective and safe vaccine at an unprecedented speed, of less than a year, which saved millions of people from one of the greatest threats to human health in modern times. It’s rather poetic that they could reduce the vaccine-making time from 10 years to 10 months ! At last, Katalin Kariko and Drew Weissman, the joint awardees of the 2023 Nobel Prize in Physiology or Medicine for their pioneering mRNA vaccine development, stopped the pandemic – hallelujah ! But, why did you call it dangerous ?”
With a wry smile, she quoted the blasting and damning ‘testimony’ of Dr. Peter A. McCullough, an American cardiologist and a professor at Texas A&M University, at an event of ‘Health & Democracy under WHO’s new proposed rules’ on September 13, 2023, around the same time as of the announcement of the Nobel Prize. The meeting was held within the European Parliament building, but, of course, the speech was not addressed to the European Parliament, as had been widely reported in the media.
DUMP COVID VACCINES
Dr. Peter said : “COVID-19 vaccines and all of their progeny and future boosters are not safe for human use. I implore you to apply all pressure and due urgency to remove the COVID-19 vaccines from the market. The spike protein – the lethal protein from the vaccines – is proven in 3,400 peer-reviewed manuscripts to cause four major domains of disease – cardiovascular, neurological, blood-clotting and immunological abnormalities.”
Bewildered, I disagreed saying that the U.S. Center for Disease Control and Prevention (CDC) has recommended at around the same time in September 2023 to vaccinate nearly all the American citizens with the new ‘updated’ / ‘modified’ COVID-19 vaccines. Absurd, Vega said. Betraying a tinge of derision, she cited various events – three Canadian doctors died after taking COVID vaccine, all within a week in July 2022; the Indian comedian movie actor Vivek died one day after being vaccinated; as of April 10, 2023, a total of 50,648 deaths caused by ‘COVID vaccines’ had been reported in ‘EudraVigilance’ alone; Novak Djokovic preferred to forego the French Open and Wimbledon titles rather than getting vaccinated; American President Joe Biden, British Queen Elizabeth II, and the young U.S. Surgeon-General Dr. Vivek Murthy got the COVID infection after receiving multiple COVID vaccinations.
Defensively, I said that airbags in cars are no guarantee against death, and that over 700,000 Americans die each year due to side effects of treatment with government-sanctioned conventional medicines and treatment protocols. Compared to this, the deaths due to COVID-19 vaccines are few and far between, considering the total number of 13,513,207,231 vaccine doses given until September 26, 2023. The ongoing ‘safety surveillance’ at the FDA of the US demonstrates that the benefits of their use outweigh their risks.
DETRIMENTAL VACCINES
Not convinced, she reinforced her stance by citing several statements -- Klaus Steger, a molecular biologist, opined that modified RNA vaccines can end up in attacking perfectly healthy cells and bypass the protective barriers in human body, like the ‘blood-brain’ barrier, as the vaccine cannot target specific cells to make viral protein; Dr. Phillip Buckhaults, a professor at the University of South Carolina testified that ‘DNA contamination’ in COVID-19 vaccines is a plausible cause for some of the rare but serious consequences like death from cardiac arrest; Dr. Harvey Risch, a professor emeritus at the Yale School of Public Health, observed that there is evidence of more cancers among those vaccinated, and said that the news reports about a new COVID variant that is expected to arrive shortly are a ‘propaganda agenda’ to sell new vaccines that are programmed to come out in a short time.
READ THE NEXT 10 PAGES FOR MORE JOLTING INFORMATION
-- for the next 10 pages, go to : https://drtramaprasad.blogspot.com/2020/02/over-healthcare.html or www.theantiseptic.in or contact : WhatsApp +91 98427 20393 / drtramaprasad@gmail.com
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Dr. T. Rama Prasad is the WORLD RECORD holder of authoring 28 articles related to COVID-19 in 30 months, published in a medical journal (The Antiseptic – www.theantiseptic.in -- Indexed in IndMED), and reporting in the same journal the WORLD’s FIRST CASE of ‘Yellow Nail Syndrome’ associated with COVID-19, PT & DM (https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html ). He wrote his first article in the premier journal, The Antiseptic, four decades ago. Many of his articles written over half-a-century may be accessed at https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html & https://drtramaprasad.blogspot.com/2017/04/my-in-newspapers_28.html & https://drtramaprasad.blogspot.com .
REGRET and RECTIFICATION
“Much as we dislike grumbling about the state of the science, the recent events related to Covid leave us with no choice but to package our message in a bundle of barbed wire. How we wish we could puff up our chest with ‘modern medical pride’ and declare in a resonant voice that ‘Modern Medicine’ is a genuine evidence-based system. Alas, however hard we try, it is becoming impossible to deny the harsh reality of ignorance, fraud and exploitation. There are legitimate concerns about how scientific research is funded, interpreted and disseminated. Scientific integrity is crucial to promote both trust in science and trustworthy science.” -- T. Rama Prasad
“It seems that we have done all the RIGHT things during the Covid pandemic, but, perhaps, in a WRONG way.” -- Dr. T. Rama Prasad
*****************************************************************
“Science is always wrong. It never solves a problem without creating ten more.”
-- George Bernard Shaw
Another mantra to bid TB adieu
Writer : T. Rama Prasad
Blog : https://drtramaprasad.blogspot.com
Email ID : drtramaprasad@gmail.com
Date : September 7, 2024
For more on this subject, go to : https://drtramaprasad.blogspot.com/2017/04/tb-and-covid.html and https://drtramaprasad.blogspot.com
Vega, a medical student, showed me the front page news report in THE HINDU of September 7, 2024 with details of a new treatment regimen for ‘Multidrug-resistant Tuberculosis (MDR-TB)’ and asked whether tuberculosis (TB) can be eliminated from India by 2025 as envisaged, with the new treatment. I said that we would be lucky if we don’t end up creating TB bacilli resistant to the new drugs (Bedaquiline, Pretomanid, Linezolid and Moxifloxacin of BPaLM regimen) also, let alone eliminating TB. Outcome of TB treatment is not like mathematics. Half-a-century ago, when ‘effective’ drugs were introduced, everyone thought that TB would be wiped out soon, and now with the introduction of a new regimen for MDR-TB, we seem to be assured of eliminating even MDR-TB soon.
It’s the natural aversion to take medicines for a long time of six months or more that makes TB invincible and insurmountable, not the dearth of effective drugs.
Drug resistance
MDR-TB remains a public health crisis and a health security threat even to people in well-developed countries. It arises out of irregular, inadequate and inefficient treatment. More than 40 years ago, I predicted and wrote in the columns of THE HINDU of April 28, 1977 that " … development of drug resistance, which is a result of inadequate and irregular treatment mostly, has far-reaching implications and if unchecked would make tuberculosis totally unmanageable by the present methods in course of time, whatever be the means. Irregular and inadequate treatment keeps the patient often alive, suffering and infective to disseminate drug-resistant organisms into the environment … "
Ground realities
The prophecy is vindicated by the Global Tuberculosis Report, 2019 of the WHO which said that India has the highest number of TB and drug-resistant TB cases in the world. It is perhaps poetic that an estimated 10.6 million people fell ill with TB in 2021, an increase of 4.5% from 2020, and 1.6 million people died in the year from TB worldwide. Globally, TB is the first leading infectious killer – a ‘durable’ killer, compared to the ‘short-time’ killer, COVID-19.
TB is killing more people than ever before in history – around 1,000 people every day in India alone, at present, and 3,500 people worldwide. And, 30,000 people get infected with TB bacilli every day across the globe. It is claimed that there had been a reduction of incidence and mortality by about 17% from 2015 to 2022 in India, but the purported decline does not change the mentioned figures significantly. Statistics of the World Health Organization (WHO) for India for 2021 gave an estimated incidence of 2,590,000 TB cases.
This chronic mortality does not become news, whereas a death due to COVID-19 grabbed the headlines. When I entered the TB field half-a-century ago, I thought that it would be hard to find a case of TB in 2020s to show to medical students for teaching purpose. Vega, the medical student, is lucky to have a lot of TB cases to study !
DREAM or DOABLE ?
A commitment was pronounced at the United Nation’s high-level meeting on TB in 2018 to end the TB epidemic by 2030 which is one of the health targets of the ‘United Nations Sustainable Development Goals (SDGs)’.
Going through the ‘India TB Report 2018 : Annual Status Report’, one gains the impression that there is a political will and a strong strategy to reach the goal of ending TB in India, much earlier, by 2025, in line with theNational Health Policy, 2017. With the will and commitment, reiterated by the prime minister often, India will be free from TB by 2025 -- a dream or doable ?
The COVID-19 pandemic has complicated the scenario of TB globally. The WHO and the researchers are of the view that the recent worsening of the TB epidemic globally is likely to be associated with the pandemic. The causes may be varied: decreased attention to TB owing to the enormous focus on COVID-19; potential biological effects of the interaction between the two diseases –- a ‘Cursed Duet’. Studies revealed that people with ‘old healed lesions of TB’ who get infected with the ‘Covid virus’ suffer more from lung function impairment and poor quality of life. The risk of death due to TB is 1 to 3 times higher in COVID-19 patients. The two diseases may be mutually aggravating. A clearer picture would emerge only after the completion of the ongoing global study on TB and COVID-19 patients, coordinated by the Global Tuberculosis Network (GTN) and supported by the WHO. Ironically, TB has remained insurmountable over a long period of time though it is preventable and curable, while COVID-19 is exiting after a short spell of three years though its prevention and cure are not yet clear. As it did with almost everything else, COVID-19 may upset the plans and targets set for elimination of TB.
Dr. T. Rama Prasad
Left to right:
Dr. T. Rama Prasad, Former Medical Superintendent (Special) of RT Sanatorium & Perundurai Medical College, (2) Dr. S. Prabhakar, Erode District Collector, (3) Thiru Thoppu N.D. Venkatachalam, Ex Minister & Perundurai MLA, (4) Dr. S. Geethalakshmi, Vice-Chancellor of the Tamil Nadu Dr. MGR Medical University, (5) Prof. Dr. M. Rajendran, Dean of the IRT Perundurai Medical College, (6) Thiru V. Shanmugan, Chairman of The Nandha Educational Trust.
Some writings, presentations, papers and comments related to TUBERCULOSIS by Dr. T. Rama Prasad:
1. https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
2. Five years Plans and TB Control Programme (Special Article) -
The Hindu, Vol.101, No. 275, November 24,1978
3. How effective is the TB control programme ? (Special Article) -
The Hindu, Vol.100, No. 274, p.8, 1977.
4. https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html
5. https://drtramaprasad.blogspot.com/2017/04/tuberculosis-in-india_29.html
6. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December;
Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in
7. https://drtramaprasad.blogspot.com/2017/04/tb-and-covid.html
8. Drug Resistance in Tuberculosis - Journal of the Indian Medical
Association, Vol. 64, pp. 264-267, 1975.
9. Childhood Tuberculosis - Part I - The Antiseptic, Vol. 76, pp. 449-504,1979
10. Childhood Tuberculosis - Part II - The Antiseptic, Vol. 76. pp. 567-574, 1979
11. Short-course Chemotherapy - The recent Advances in the Treatment
of Respiratory Tuberculosis - Current Medical Practice, Vol.24,
pp. 41-46, 1980.
12. Drugs in the treatment of Tuberculosis - The Antiseptic,
Vol. 75, p.678, 1978
13. Chemotherapy of Tuberculosis - The Antiseptic, Vol. 76, p.248, 1979.
14. Streptomycin in Tuberculosis - The Antiseptic, Vol. 76, p.516, 1979.
15. National Tuberculosis Control Programme - views presented,
on invitation by theTuberculosis Association of India, at the 32nd
National Conference on Tuberculosis and Chest Diseases, 1977.
16. Correlation between Geomagnetic Activity and Haemoptysis -
paper presented at the II Tamil Nadu State Conference on Tuberculosis
& Chest Diseases, 1980.
***********************************************************
ABOUT THE AUTHOR,
Dr. T. Rama Prasad
“ Dr. T. Rama Prasad is the WORLD RECORD holder of authoring 28 articles related to COVID-19 in 30 months, published in a medical journal (The Antiseptic – www.theantiseptic.in -- Indexed in IndMED), and reporting in the same journal the WORLD’sFIRST CASE of ‘Yellow Nail Syndrome’ associated with COVID-19, PT & DM (https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html ). Interestingly, he reported the first case of YNS from India in an American medical journal long ago in 1980. He wrote his first article in the premier journal, The Antiseptic, four decades ago. Many of his articles written over half-a-century may be accessed at https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html & https://drtramaprasad.blogspot.com/2017/04/my-in-newspapers_28.html & https://drtramaprasad.blogspot.com . He is the former MEDICAL SUPERINTENDENT (Special) of R.T. Sanatorium & Perundurai Medical College and Research Centre.”
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TO KNOW MORE ABOUT TEA & COFFEE
STORM in a CORONA TEACUP ...
CHEERFUL COFFEE NEWS … July 2017
CONTROVERSIES
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TEA -- the Good and the BAD
The Tea Board has often urged the public to drink more tea to lower the risk of heart disease, stroke and cancer ( The Hindu, Sept. 25, 2001), quoting scientific literature on the value of tea in protecting people from these diseases, but conveniently ignoring literature on the possible and proven adverse effects of excessive tea consumption.
Green tea, black tea, white tea, oolong tea, pu-erh tea, and so on are all derived from the plant Camellia sinensis, native to China and India. Tea has for long been considered to be a healthy drink full of flavonoids and other goodies like antioxidants that have a variety of positive health benefits — reducing risk of cardiovascular diseases, stroke, cancer, obesity, infections, osteoporosis, hypertension, neurological disease, cognitive impairment, and so on. Scientific literature carries evidence in favour of tea, especially green tea which has more than 30 polyphenols and a catechin called epigallocatechin (EGCg) which act on the human system in positive ways.
No doubt, tea leaves are generally and nutritionally good, like many other leaves we use in our diet, but the tall claims are commercially motivated. A little tea may be good, but it is unduly glorified by business. And now it seems it makes business sense to get children addicted to tea. They are already victims of irresistible commercial junk food that is unfit for human consumption.
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
The Hindu (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. DIGITAL CLUBBING and HYPERTROPHIC PULMONARY OSTEOARTHROPATHY - Pathogenesis --
The Antiseptic, Vol. 76. pp. 213-215, 1979.
2. CHILDHOOD TUBERCULOSIS - Part I -- The Antiseptic, Vol. 76, pp. 449 - 504, 1979
3. CHILDHOOD TUBERCULOSIS - Part II -- The Antiseptic, Vol. 76, pp. 567 - 574, 1979
4. STEVENS-JOHNSON SYNDROME and THIOACETAZONE -- The Antiseptic, Vol. 77, pp. 99 -102, 1980
5. HIGHLY PURIFIED INSULINS - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
7. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
9. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
10. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 --
……http://www.thehindu.com/opinion/open page/article2801701.ece
11. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012 --
...http://www.thehindu.com/opinion/open-page/article3340116.ece
12. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 --
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
13. A BAD PATCH - The Hindu, Open Page, March 15, 2020 --
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
14. YELLOW NAIL SYNDROME - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
15. YELLOW NAIL SYNDROME - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
16. DRUG RESISTANCE in TUBERCULOSIS - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
A short list of some of the published articles authored / co-authored by Versha Rajeev:
1. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
2. Antiseptics, Disinfectants and COVID-19 – THE ANTISEPTIC, Vol. 117,
No. 11, pp. 26 – 28, 2020
3. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
4. The Conundrum of COVID-19 Vaccines – THE ANTISEPTIC, Vol. 118, No. 1, 2021
5. The Good and the Bad of Honey
SAGITTARIUS ... 27.03.2019
Sagittarius, the half human and half horse, is the centaur of Greek mythology, the learned healer whose higher intelligence is believed to form a bridge between Earth and Heaven ... also known as Archer. It is the ninth astrological sign of Zodiac, which is associated with the constellation Sagittarius. Depicted as a centaur, Sagittarius aims his arrow at Scorpius in the sky. NASA's 'Hubble Space Telescope' is used in the project called "Sagittarius Window Eclipsing Extrasolar Planet Search" to find potential stars that have characteristics of exoplanets.
The following is the list of the “SCRIBBLINGS.” A click on any of them would open the respective ‘scribbling’.
Blog Archive
· ▼ 2017 (115)
o ▼ March (1)
o ▼ April (112)
§ Science and Nonsense about COVID
§ WORLD CANCER DAY ..February 4, 2017
§ GRADUATION DAY -- 2018, Perundurai Medical Col...
§ "AHIMSA"
§ OMICRON
§ QUOTES
§ POLLUTION, Disease and Deepaavali
§ SILENT, ISOLATED and INSULATED
§ To live in INDIA or ABROAD ?
§ KMCH
§ FISHES
§ SUNDAY LUNCH ... Dec 3, 2017
§ BAHUBALI
§ DIABETES
§ MY ART
§ CANCER
§ DOGS
§ GOD-MEN
§ CODUP
§ LOCKDOWN MEDICINE -- too toxic ?
§ YOGA
§ HCQ, IVERMECTIN, CORONAVIRUS and FRAUDS
§ SWINE FLU -- A (H1 N1) influenza
§ PERUNDURAI MEDICAL COLLEGE & SANATORIUM campus
§ RAJYALAKSHMI RAMAPRASAD and PLANTS
§ GIRL CHILD : GOLDEN CHILD ; WOMEN POWER
§ ASTHMA, ALLERGY, COPD and ILD
§ RAPE
§ MARKETING TRICKS & INNOVATIONS
§ MODERN MEDICINE -- the Good, the Bad and th...
§ RAJYALAKSHMI & International Women's Day 2024
§ SHIVA, KRISHNA, Ramanuja & Ramanujan
§ OUR LOVE STORY & good old days
o ▼ May (2)
· ▼ 2019 (1)
o ▼ January (1)
· ▼ 2020 (3)
o ▼ February (1)
o ▼ April (1)
§ RAJYALAKSHMI RAMAPRASAD and RADIOGRAM
o ▼ June (1)
§ CORONAVIRUS COVID-19 (SARS-CoV-2)
· ▼ 2022 (1)
o ▼ October (1)
· ▼ 2023 (8)
o ▼ January (6)
§ INDIAN IMMUNITY, BCG and COVID
§ WOW !!!
§ COVID vaccines -- Safe or Unsafe ?
o ▼ August (1)
§ RAMAYAAN
o ▼ October (1)
· ▼ 2024 (1)
o ▼ May (1)
·
GORU used to dance in the attire of 'Child Krishna', but the 'Bhagvan' didn't sanction her a full life.
An anecdote about “GORU”
During my childhood, one of my schoolmates had huge nails. Her name was Gowri. We nicknamed her as ‘Goru’ (‘goru’ in Telugu means nail of a finger or toe ). They used to say that her huge nails caused a problem in her heart. It might be a case of ‘Digital Clubbing’ (abnormal nails present in some ‘Congenital Heart Diseases’). After one summer vacation, ‘Goru’ didn’t come back to the school. It was learnt that she died due to the nail / heart problem, and that treatment could not be availed as they didn’t have money to pay for it.
Perhaps, this incident prompted me to look at everyone’s nails from that time which might have led me to report the first case from India of ‘Yellow Nail Syndrome (YNS)’ from India in 1980 (published in an American journal, CHEST) and the first case in the world of ‘Yellow nails & Covid’ in 2023, published in an Indian journal, THE ANTISEPTIC - https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html
And perhaps, the preventable death of ‘Goru’ due to the inability to pay for the treatment motivated me to start my ‘PAY WHAT YOU CAN’ Clinic (PWYCC) half-a-century ago where patients may pay whatever they can. No fixed fee ( http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html ). The credit for these case reports on YNS and the starting of my PWYCC should go to ‘Goru’. Thanks to “Goru”.
-- T. Rama Prasad
More at : https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html
This is not an ad, it’s about an odd service.
GREETINGS from
‘PAY WHAT YOU CAN’ Clinic
“Thena thyakthena bhoojithaha”– Ishopanishad
( Translated by Prof. B.M. Hegde as: “Rejoice in giving.”)
True to this quote, I have been rejoicing at what little I could give. Defying stereotypes, this clinic has been in existence for a very long time, sans glitz, blitz, ads, microphones, speeches and noise. As a matter of my policy, publicity is shunned. The reason is simple. Good work needs no noise and nonsense. My ‘SCRIBBLINGS’ on related topics may be accessed at: http://drtramaprasad.blogspot.com
My consultation fee is not decided by me. It is the patient’s pleasure. The patient may pay (donate) whatever he can and what he wishes. If one is short of money, he or she need not pay anything. The money may just be put into the ‘hundi’ box kept outside the consultation room. And the money thus received is used for charity to help the needy, the poor and the less fortunate. If interested to know more about this facility, go to: http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html . And, if you wish, you may also 'contribute what you can' through bank (Dr. RAMA PRASAD T, A/C No. 451075868, INDIAN BANK, IFS CODE IDIB000P155, PERUNDURAI, Erode District, Tamil Nadu - 638052 ).
"We need not run after money. If we are meritorious and compassionate, money would run after us, and it eludes us if we run after it.” -- T. Rama Prasad
“Richness is not having lots of money. It is the feeling that one has enough of it. Contentment sans comparison is what makes one really rich.” -- T. Rama Prasad.
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Consult your local doctor before rushing to me
Most ailments can be cured at local level
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